MEDI602 Phase 2 Handbook

2016 - 2017

WELCOME

Welcome to Phase 2 of the MBBS course. This handbook will provide you with general information about the rotations, particulars about assessment, lists of useful contacts, and links to other resources. It also represents the Subject Outline for this part of the course, which is officially entitled MEDI602. Please read this handbook before your first day on the wards. You will probably find it answers any questions you might have, or it will show where to find the answer. If ALL ELSE fails, you can contact me in my capacity as the Acting Chair of Phase 2.

Kind regards and very best wishes,

Professor Wilf Yeo Associate Dean: Teaching Hospitals Professor of Medicine and Clinical Pharmacology Acting Chair: Phase 2

PHASE CHAIR - CONTACT INFORMATION

Name: Professor Wilf Yeo Acting Chair: Phase 2 Address: The Wollongong Hospital Academic Unit Block C, Level 8, The Wollongong Hospital Crown Street Wollongong NSW Phone: +61 2 4221 4506 Facsimile: +61 2 4253 4838 Email: [email protected]

Name: Professor Nagesh Pai Acting Chair: Phase 2 Address: The Wollongong Hospital Academic Unit Block C, Level 8, The Wollongong Hospital Crown Street Wollongong NSW Phone: +61 2 4221 4071 Facsimile: +61 2 4253 4838 Email: [email protected]

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CONTENTS

KEY CONTACTS 3 SUBJECT DESCRIPTION AND OBJECTIVES 6 GENERAL INFORMATION 7 TEACHING IN PHASE 2 8 PRACTICALITIES 12 ETHICAL AND LEGAL ISSUES 13 QUALITY ASSURANCE AND EVALUATION 15 STUDENT ASSESSMENT 16 STUDENT SUPPORT 22 STUDENT ACCOMMODATION: WOLLONGONG 24 STUDENT ACCOMMODATION: SHOALHAVEN 25 STUDENT ACCOMMODATION: SOUTHERN HIGHLANDS 24 STUDENT ACCOMMODATION: CONTACTS 28 APPENDIX A – TIMETABLE OF ASSESSMENT AND DEADLINES FOR SUBMISSION 29 APPENDIX B – PHASE 2 KEY DATES 30 APPENDIX C – PHASE 2 ON-CAMPUS DATES 31 APPENDIX D – PHASE 2 ON-CAMPUS DAYS 32 APPENDIX E – PHASE 2 ON-CAMPUS DAYS SESSION 2 33 APPENDIX F – LEARNING OUTCOMES 34 APPENDIX G – MBBS CLINICAL COMPETENCIES, SKILLS & PROCEDURES 37 APPENDIX H – NURSING ATTACHMENT LEARNING ACTIVITY OUTLINE 46 APPENDIX I – NURSING ATTACHMENT SPR 47 APPENDIX J – PHASE 2 BOOK LIST 48 APPENDIX K –SUMMATIVE CEXS FORM 49 APPENDIX L – FORMATIVE CEXS FORM 50 APPENDIX M – STUDENT PERFORMANCE REVIEW (SPR) FORM 51 APPENDIX N – STUDENT P-DRUG FORMULARY 53 APPENDIX O – PPD REFLECTION ASSIGNMENT 63 APPENDIX P – PPD REFLECTION MARKING RUBRIC 64 APPENDIX Q – RCA ASSIGNMENT SUBMISSION GUIDELINES 65 APPENDIX R - RCA SUMMATIVE ASSESSMENT TASK 66 APPENDIX S - RCA ASSESSMENT TASK: NHMRC 68 APPENDIX T - RCA POEM MARKING SHEET 70 APPENDIX U - RCA CRITICAL ANALYSIS OF A DRUG ADVERTISEMENT 72 APPENDIX V - RCA MARKING SHEET: CRITICAL ANALYSIS OF A DRUG ADVERT 75 APPENDIX W – NATIONAL PRESCRIBING CURRICULUM (NPC) ONLINE MODULES 77 APPENDIX X – ADDRESSING LEARNER DISORIENTATION: GIVE THEM A ROADMAP 78

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KEY CONTACTS

Clinical Placements Tracy Metcalfe [email protected] Wollongong Hospital Rebecca Ciocca 4221 3957 [email protected] Melanie Sharp [email protected] Leanne Betts placements- Shoalhaven Hospital 4429 1504 Liz Melleuish [email protected] Bowral & District Hospital and Southern Alice Campbell-Jones 4861 1571 [email protected] Highlands Private Hospital Tamica Haines Mental Health Rotation Kerry Dawes 4221 5330 [email protected] Academic Leaders Regional Hospital Academic Leader: Dr H. John Fardy 4221 4122 [email protected] Illawarra Hospitals Regional Hospital Academic Leader: Bowral Dr Joshua Florida 4861 0186 [email protected] Senior Lecturer Clinical Education: Bowral Dr Irshad Ali 4861 1571 [email protected] Senior Lecturer Clinical Education Dr Taff Hughes 4423 9570 [email protected] Shoalhaven Hospital Clinical Associate Deans Associate Dean: Teaching Hospitals Prof Wilf Yeo 4252 8839 [email protected] Clinical Associate Dean: Southern Highlands Dr John Barnett 4861 4555 [email protected] Specialty Leaders/Lecturers Medicine Professor of Medicine Professor Wilf Yeo 4221 8839 [email protected] Diane Turton [email protected] Assistant to the Professor of Medicine 4221 8839 Rebecca Ciocca (Friday) [email protected] Associate Professor of Medicine & Infectious A/Prof Spiros Miyakis 4221 3818 [email protected] Diseases Senior Lecturer in Pharmacology and Lou Gaetani 4221 8840 [email protected] Therapeutics Surgery Associate Professor of Surgery A/Prof Tim Skyring 42213049 [email protected] Associate Professor of Surgery A/Prof Hunter Watt 4221 4114 [email protected] Psychiatry Professor of Psychiatry Professor Nagesh Pai 4221 4071 [email protected] Lecturer in Mental Health Kerry Dawes 4221 5330 [email protected] Senior Lecturer in Mental Health Bev Rayers 4222 5294 [email protected] Maternal & Women’s Health Academic Leader M&W’s Health A/Prof Lionel Reyftmann 4221 3990 [email protected] Senior Lecturer M&W’s Health Dr Bindu Murali 4221 3990 [email protected] Senior Lecturer M&W’s Health (Bowral) Dr Joshua Florida 4861 1571 [email protected] Child and Adolescent Health Professor of Child and Adolescent Health Professor Ian Wright 4221 4015 [email protected] Senior Lecturer in Paediatrics (Illawarra) Dr Joanne Morris 4253 4298 [email protected] Lecturer in Paediatrics (Illawarra) Dr Corinne Langstaff 4221 5233 [email protected] Senior Lecturer in Paediatrics (Shoalhaven) Dr Mark de Souza 4423 9570 [email protected] Senior Lecturer in Paediatrics (Bowral) Dr Richard Hart 4861 1571 [email protected]

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KEY CONTACTS

Useful Phase 2 Contacts

Clinical Placements Manager Jenny Deura 4221 3990 [email protected] Curriculum Manager Jodie Douglas 4221 5964 [email protected] Director of Curriculum A/Prof Kylie Mansfield 4221 5851 [email protected] 4221 4907 Head of Students Dr Louise Wright [email protected] 0408912075 http://www.library.uow.edu.au/ask/UO Medical Librarian 4221 3548 W026599.html Professor of Physiology Prof Peter McLennan 4429 1502 [email protected] Associate Professor: Medical Education, A/Prof Lyndal Parker- 4429 1502 [email protected] Head, GSM Shoalhaven Newlyn Academic Leader: Research and Critical Analysis Dr Kath Weston 4221 5633 [email protected] Academic Leader: Personal and Professional Dr Coralie Wilson 4221 5135 [email protected] Development Academic Leader: Clinical Skills Dr Helen Rienits 4221 5634 [email protected] Medical Education Team regarding the CBLs [email protected]

Facsimile Numbers:

Wollongong Hospital Clinical Placements 4253 4835 Wollongong Hospital Academic Suite 4253 4838 Shoalhaven Hospital 4423 9559

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SUBJECT DESCRIPTION AND OBJECTIVES

SUBJECT DESCRIPTION The subject focuses on four themes in an integrated process of delivery: Medical Sciences, Clinical Competency, Research and Critical Analysis, and Personal and Professional Development, building on the content delivered in Phase 1 of the MBBS course (MEDI601). Most of the students’ time is spent engaged in clinical experiences while attached to clinical teams in rotations that encompass Medicine (including Acute Medicine), Surgery (including Anaesthetics and Intensive Care), Women’s and Maternal Health, Child and Adolescent Health, and Mental Health. Further details are provided later in this document.

SUBJECT OBJECTIVES All learning outcomes are addressed from the beginning of the course and are relevant to all subjects. The levels of achievement have a hierarchical structure that reflects the nature of learning experiences, the methods of assessment, and the expected standards: 1. The acquisition of knowledge and/or skills. 2. Understanding of how the knowledge and/or skills may be applied. 3. Demonstrated ability to apply the knowledge and/or skills (i.e. may be in a laboratory or clinical simulation). 4. Demonstrated ability to apply the knowledge and/or skills in a real clinical practice environment. 5. Demonstrated performance (i.e. effective application) of the knowledge and/or skills in a clinical practice environment. The learning outcomes for Phase 2 are shown in Appendix F.

RESTRICTIONS ON ENTRY Satisfactory completion of MEDI601

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GENERAL INFORMATION

SUBJECT ORGANISATION

MEDI602 (Phase 2) Session 1 2016, Session 2 2017 Credit points 48 Contact hours per week 6 hours (supplemented with on-line material) Clinical Placement hours per week 24 – 32 hours

Students should check their eLearning space regularly as important information will be posted from time to time. Any information posted to the web site or via SOLS message or Announcement Alert is deemed to have been notification to all students.

POLICIES Students must adhere to governing legislation or other codes of conduct appropriate to the University, the health and medical profession or workplace for clinical experience. These include, but are not limited to:

Professional and Legislation - Code of Conduct – NSW Health - Occupational Assessment, Screening & Vaccination Against Specified Infectious Diseases - Work Health and Safety Act 2011 and the Work Health and Safety Regulation 2011 - Children and Young Persons (Care and Protection) Act 1998 - Health Records and Information Privacy Act 2002 (NSW) - Public Interest Disclosures Act 1994 (NSW) - NSW Health Policy Directive PD2005_548 Student Training and Rights of Patients

University of Wollongong - The Student Charter - Responsibilities Rights and Respect Online (RRR Online) - UOW Student Conduct Rules - UOW Code of Practice – Student Professional Experience - Academic Integrity Policy - Student Academic Consideration Policy - Course Progress Policy - SMAH Graduate Qualities - Academic Complaints Policy (Coursework and Honours Students) - Attendance Guidelines for students at UOW’s Graduate School of Medicine - Social Media and Medical Students: a guide to online professionalism for medical students in the Graduate School of Medicine - GSM Student Complaints and Grievances - Inclusive Language Guidelines - Workplace Health and Safety Policy - IP Intellectual Property Policy

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TEACHING IN PHASE 2

Phase 2 is essentially hospital-based and consists of 7 rotations each lasting 5 weeks:  2 rotations in Medicine (at least 1 at TWH)  2 rotations in Surgery (at least 1 at TWH)  1 rotation in Child and Adolescent Health  1 rotation in Maternal and Women’s Health  1 rotation in Mental Health (to be based in the Illawarra, either TWH or Shellharbour Hospital)  All students must complete at least one rotation at either Shoalhaven Memorial Hospital or Bowral District Hospital.  For students undertaking 4 rotations at Shoalhaven (based on exceptional circumstances), you MUST complete Mental Health, 1 Medicine and 1 Surgery at TWH.  Students undertaking 4 rotations in Shoalhaven will not be permitted to undertake rotations at Shellharbour Hospital. Anaesthetics and Intensive Care Medicine will be incorporated into the Surgical rotations, and some Emergency Medicine will be incorporated into the Medicine rotations. It is the policy of the GSM that students should experience the practice of medicine in rural hospitals (such as Bowral and Shoalhaven) and a larger teaching hospital (Wollongong). Generally, pairs of students will be allocated to clinical teams and individual consultants will be responsible for each pair. In some larger teams, several pairs of students may work together. At the completion of the rotations there will be a wrap-up week of Phase 2 activities, followed by a study week, then the end-of-phase examination week (integrated written examination and an Objective Structured Clinical Examination [OSCE]). Please refer to the year planner on your eLearning Space.

ON-CAMPUS DAYS In the first 6 months (i.e. during Rotations 1-4) you will spend alternate Mondays and Fridays on-campus. Students on hospital rotations at Shoalhaven and Bowral will attend the Shoalhaven campus; students on hospital rotations at Wollongong and Shellharbour will attend the Wollongong campus. The fortnight timetable and template for the on-campus days in weeks 1 – 20 are shown in Appendix D. In addition to the formal teaching activities you will have one GOAL per week. You are expected to have the GOALs completed before the second on-campus teaching day in each fortnight (i.e. the Friday). In a change from the Block structure in Phase 1, the topics for study in Phase 2 have been arranged by clinical topics. In Rotations 5 -7 there will be on-campus days which are alternate Fridays. Please see Appendix E.

CLINICAL DAYS Apart from the on-campus days, the other weekdays will be available for clinical experience in your teams. Your activities will be organised by your preceptors, but we expect you to spend 24-32 hours per week actually engaged in clinical activity. The structure of your week will be determined by the work patterns of the clinical teams.

MISSED CLINICAL EXPERIENCE Clinical experience is an essential component of the MBBS and 100% attendance is required and expected in all clinical placements. The following rule refers only to missed time with APPROVED STUDENT ACADEMIC CONSIDERATION. In Phase 2, students will be required to make up days/hours should they miss more than 5% of any rotation with approved Student Academic Consideration (5% = 1 day, i.e. 7 hours). Students will be required to make up days should their combined absence in ALL rotations be greater than 5% of the total Phase 2 clinical placement requirements. (With approved Academic Consideration, 5% = 5 days for the entire Phase 2.) For further information, refer to the GSM policies: Student Academic Consideration and Student Absence in Phase 2 Attendance Guidelines for students at the UoW’s Graduate School of Medicine For absences that do not fall within the above criteria, please discuss with the Head of Students.

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TEACHING IN PHASE 2

USE OF THE CLINICAL LOG Clinical placements do not always lead to an entirely predictable range of student experiences, and the Clinical Log is a vital tool in helping you to identify gaps in your experience. Recording your clinical activities in the clinical log is compulsory during Phase 2 as in Phase 3 the Clinical Log is used to measure performance. It is expected that you enter a record of all experiences with patients, particularly where you have had a significant role to play, i.e. examination, history, procedure. There are two forms of entry in the log:  The ‘short entry’ form is for logging the majority of your patient experiences. This is a shorter version of the previous form (which you will have encountered in Phase 1) so that only the essential data is collected, making it faster to log all your experiences.  The ‘long entry’ form is for interesting or unusual cases that you would like to record for discussion with your Preceptor or to share with your peers. It is expected that you will complete at least one long entry each week. The Clinical Log is the tool whereby your experience and performance can be tracked by you, your preceptor and the academic staff of the GSM. We encourage you to share the output of your log to show your preceptor a list of the range of cases you have encountered during the placement. Before meeting with you preceptor, select several cases you would like to focus on in your discussion with your preceptor. Use the cases to identify particular aspects of performance you would like your preceptor to help you improve on. Also use your logbook to show your preceptor a summary of the breadth cases you have seen. Where the breadth is too thin, the logbook evidence can help your preceptor work with you to improve your exposure to an appropriate range of cases. On some rotations, your preceptors may additionally require you to use paper records to document your experience, but you still need to complete your log. Reports from the GSM on your Clinical Log usage will also be provided throughout the year to you. The School is working to keep the log as simple and easy to complete as possible. By the time you get to Phase 3 it is going to be very important for you to know where the gaps in your experience are, and to use that information to seek out clinical experiences that give you a strong base for your learning.

CASE BASED LEARNING (CBL) Case Based Learning (CBL) activities in Phase 2 have been designed to allow students to integrate their learning in all themes and develop their clinical reasoning. CBL activities in Phase 2 are delivered in each clinical rotations in which students are working to give a better contextual understanding of the scientific and clinical knowledge. CBL activities in Phase 2 aim to:  provide a framework for students’ core learning in system/specialty based cases  further develop the core clinical presentations introduced in Phase 1  further develop self-directed learning skills and the ability to access and evaluate appropriate literature  refine problem solving skills in more complex cases and with greater depth of understanding  develop students clinical reasoning, or how as clinicians we explore a patient’s presenting problems and determine appropriate management  consider the clinical problems in a hospital context and in the context of specialty based medical care If you have any questions or comments regarding Phase 2 CBL please contact the Medical Education team on gsm- [email protected].

STUDENT GRAND ROUNDS AND RESOURCES All students will be allocated to present a long case during their medicine and surgery rotations. Please refer to the Medicine and Surgery Rotation guide for more information. The GSM would like to encourage the sharing of presentations online from Student Grand Rounds in Phase 2. At the end of each Student Grand Round, GSM staff will collect the presentations and, with the permission of each student group, upload them into the eLearning space. The presentations will be reviewed to ensure patient confidentiality and an additional slide will be added outlining the 4 key learning points on the case from the Speciality Leader’s perspective. The presentations will be accessible through the Student Grand Rounds folder on the eLearning space.

SIMULATION TRAINING During Phase 2, students will be involved in 4 Simulation Training (Emergency Medicine Skills) sessions throughout the year. SIM sessions will be held during normal Clinical Skills lessons on campus days. Each SIM lesson, one student group will be utilising the facilities at ISHEC for their training; the other groups will be at Wollongong campuses.

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TEACHING IN PHASE 2

ATTENDANCE AT CLINICAL SKILLS Attendance for all clinical teaching sessions is compulsory with 100% attendance expected. If there is an absence noted for a student, explanations will be sought and if it falls outside the usual definitions of Academic Consideration, this information may be considered by the Board of Examiners to determine whether a student may progress to Phase 3. These sessions run with small numbers of students and there is a responsibility by each student towards the learning of all students in the group. Students also have a responsibility to the volunteers and external clinicians who may be participating in these teaching sessions. If students are absent then this has a direct impact on the clinical skills team and the learning of all. Phase 2 on campus venue allocations are automatically tied to your placement and group sizes must be maintained. Groups are based on the capacity of Clinical Skills.  Placement: Shoalhaven/Bowral =>On Campus Days: Shoalhaven  Placement: Wollongong/ Shellharbour =>On Campus Days: Wollongong

Students may swap campus day locations with another student by: 1. Emailing Jenny Tompson: [email protected] (don’t forget to cc: the other swapper) with the following details a. Names of two students: ie the “swapper” and the “swapee” b. Rotation Number: c. Location: ie Student X swapped from Wollongong to Shoalhaven, Student Y swapped from Shoalhaven to Wollongong. Make the information clear. 2. 2 WEEKS NOTICE is required, requests with less than 2 weeks notice before the start of rotation WILL NOT be considered (please note closing dates below). After this time only requests with Academic Consideration will be considered via official submission of AC (see Academic Consideration guidelines). 3. The “swaps” are for the full 5 weeks of the rotation. The GSM will NOT consider requests for anything different. 4. Closing dates for swap requests: Rotation 1: Monday 18th July 2016 Rotation 2: Monday 8th August 2016 Rotation 3: Monday 26th September 2016 Rotation 4: Monday 7th November 2016 Rotation 5: Friday 20th January 2017 Rotation 6: Friday 17th February 2017 Rotation 7: Friday 7th April 2017

TEXTBOOKS AND OTHER LEARNING RESOURCES A list of recommended texts is provided for this phase (Appendix J). Copies of these texts are available at Wollongong and Shoalhaven campus libraries as well as in the core text collections located in the GSM Learning Centres at Wollongong and Shoalhaven. However, this list is not exhaustive and there are a wide range of other resources available through the UOW Library (http://www.library.uow.edu.au/). Save yourself time and enhance your studies: connect with information specialists and resources anytime, anywhere. Ask Us: http://www.library.uow.edu.au/ask/UOW026599.html or Google - uow library ask us Online – Ask a Librarian Ask questions and receive a response within 1 business day In person – Book a Librarian 30-minute appointment with an Librarian Research Consultation Service 1 hour appointment with an information specialist. Available to UOW academics, HDRs, postgraduates, Honours, Masters and GSM students. By phone (02) 4221 3548 Please be responsible with the Library books as many go missing and this causes considerable distress to other students during examination revision time.

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TEACHING IN PHASE 2

NURSING ATTACHMENT This is a SUMMATIVE task with due dates listed in the Assessment Calendar. Failure to do these will mean failure in the subject. You will spend two full shifts shadowing a ward nurse (this EXCLUDES the Birthing Unit, Emergency Department, Endoscopy Unit, Intensive Care Unit, Pathology and Recovery). We recommend this during Surgery or Medicine rotations.

One shift will be during the first 4 rotations (Rotations 1 – 4) The other will be during the last 3 rotations (Rotations 5 – 7)

It is strongly recommended that you do your second Nursing Attachment early in the last 3 rotations as you will be very busy as the exams approach. Many students choose to do the Nursing Attachment on the weekend so that they do not miss any of the Clinical Attachment activities scheduled during the week. You will have to make your own arrangements directly with your Nurse Preceptor. At the end of each nursing attachment, the ward nurse will complete the Nursing Attachment SPR form, (Appendix I) to provide feedback on the student’s personal and professional behaviour during the attachment. Each student should record key events or learning experiences that occurred during the placement in their clinical log. Such events or experiences may form the basis of a subsequent portfolio reflection written assessment task.

NURSING ATTACHMENT – EXEMPTION If you have a background in nursing, i.e. qualifications as a Registered Nurse, you will be exempt from completing the two nursing attachments. Please arrange to get a copy of your nursing qualification/registration documents to the Manager of Clinical Placements, Jenny Deura.

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PRACTICALITIES

ORIENTATION TO HOSPITAL SITES When you attend the hospital you will be required to undertake an induction session that may include occupational health and safety briefings, allocation of lockers, issuing of passwords and name badges, etc. The Clinical Placement Facilitators will provide you with details on an individual basis.

MEDICAL EQUIPMENT Although any equipment you might need should be available on the wards, there are some items that it is useful to own yourself. Make sure they are clearly labelled with your name (by engraving if possible).  Stethoscope. Students are required to provide their own stethoscope suitable for the task. The performance and reliability of the instrument is generally considered to be proportional to its price.  Tape measure. This will prove remarkably handy and should not be expensive.  Pocket torch. A pen torch is ideal.

WRITING IN PATIENT RECORDS (NOTES) You may be required to write in the patient’s clinical notes. If you do, remember to clearly indicate you are a Medical Student, sign and date the entry, and provide a legible copy of your name. You may also be required to identify your entry with a medical student sticker (see below). These stickers are available in the student common area.

MED STUDENT

Practice in this respect will vary. Do not write in the patient records unless you know that you should do so and you are aware of what is expected of you. Seek advice from your preceptor or Regional Hospital Academic Leader if you are unsure.

ON-CALL We expect some of your experience to be out of hours, i.e. at night and weekends. Your Preceptors will let you know how you should keep in contact with the team.

ALCOHOL AND OTHER DRUGS Students must adhere to UOW policies and guidelines on Alcohol and Drugs in the Workplace while on placement. If a student is not on-call and has consumed alcohol or other drugs, and their Preceptor contacts them in relation to an opportunity to access clinical experience after hours (i.e. delivery of a baby or attendance at a motor vehicle accident), the student must not participate in this clinical experience and explain the reason. Students who are on-call must not consume alcohol or other drugs.

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ETHICAL AND LEGAL ISSUES

You are bound by legal and ethical codes of conduct in your behaviour in relation to patients, colleagues and anyone else you meet in the course of your clinical experience. These principles apply to staff and students alike. PRIVACY AND CONFIDENTIALITY All information about people who are being treated or have been treated in hospital or by other health services must be regarded as confidential. This applies to confirmation that they are a patient in hospital as well as details of their condition. Such information must not be released without the consent of the patient or their representative. If in doubt, seek advice from your preceptor before disclosing any information to anyone not directly involved in the care of the patient. Before you commence Phase 2 you will be required to sign a Confidentiality Agreement that outlines situations you will find yourself confronted with not only in Phase 2 but throughout your degree. One of the most common problems is medical students discussing patients in public places (corridors, lifts, hospital tea rooms and public areas away from the hospital, etc.). Please take care not to do this. Not only does it give a poor impression, but it also has significant legal implications, even for students. Someone nearby may be a friend or relative who is familiar with the case and knows who you are talking about, even if you don’t use names. The use of social media to discuss patients and activities in the hospital may also potentially damage personal integrity, doctor-patient and doctor-colleague relationships, and future employment opportunities. Please familiarize yourself with the document “Social Media and Medical Students: a guide to online professionalism for medical students in the Graduate School of Medicine at the University of Wollongong” For insertion into the hospital medical record, full identifiers are needed but for a student’s clerking that are solely for student learning, the regulations pertaining to privacy (omitting or modifying patients identifiers) apply. For further information, please refer to the Health Records and Information Privacy Act (2002).

EXAMINATION OF PATIENTS Although most patients do not object to assisting with medical student training, students do not have an absolute right to examine any patient in the hospital. When you commence a new clinical attachment, check with your Preceptor on the procedure to be followed when approaching patients and seeking their consent to be interviewed and examined. This may vary slightly according to the clinical discipline involved and may even vary between hospitals. Examinations of an intimate nature (rectal, vaginal, breast) require specific consent from patients and supervision by your Preceptor. Discuss this with them and make sure you follow the correct protocols. Students are required to comply with the NSW Health Policy Directive PD2005_548 Student Training and Rights of Patients.

NAME BADGE In line with a recommendation of the Garling Inquiry, it has been requested that all medical students are to wear a name badge when in Illawarra Shoalhaven Local Health District (ISLHD) facilities. The name badge you have been issued with by the GSM is appropriate and you are required to wear it at chest level. ISLHD acknowledges that you should not wear this name badge when in areas of risk, i.e. Mental Health rotations, and you will be issued with an alternative name badge for these rotations at the orientation session. Please ensure that you follow this directive. You have been issued with a name badge; a replacement badge will cost you $15. Following is the link and the steps to follow to order and pay for a GSM name badge: 1. Click or go to the following link. http://smah.uow.edu.au/medicine/current-students/mbbs/index.html 2. Select on the UOW Student E-Payment System 3. Select Graduate School of Medicine 4. Select GSM Student Name Badges 5. Fill in details and submit for payment

STUDENT DRESS Appropriate, professional dress is a requirement when interacting with patients. This represents a component of the professional behaviour we expect from our students. Appropriate dress is also necessary to ensure personal and patient safety, and to maximise prevention of infection. Some key requirements will include: changing contaminated clothing immediately; compliance with regulation footwear or uniform (when in place); discreet application of makeup/perfume; tying back long hair; removal of false nails and minimal jewellery. Students should also maintain good personal hygiene.

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ETHICAL AND LEGAL ISSUES

WORK HEALTH & SAFETY UOW is committed to the prevention of injury and illness to staff and students, including the management of risk to students, staff or equipment during placements. Students must adhere to WHS requirements in each of the settings where they undertake their placement, which includes:  take reasonable care for their own health and safety  take reasonable care for the health and safety of others  comply with any reasonable instruction by the host organisation or University  co-operate with any reasonable policies and procedures of the host organisation or University e.g. identifying and reporting hazards to their supervisor. Students are also required to take necessary precautions at all times during their academic and personal activities in a range of settings, including accommodation and travel to and from placement activities. (Students must take particular care when driving at night or on country or unfamiliar roads). The following table may assist to alert students to potential hazards:

Could people be injured or made sick by: Imagine that a child was to enter your work area Noise, light, infection, high or low temperatures, electricity, - What would you warn them to be extra careful of? moving or falling things (or people). - What would you do to reduce the harm to them?

Can workplace practices cause injury/illness? - Are there heavy or awkward lifting jobs? What could go wrong? - Can people work in a comfortable posture? - What if equipment is misused? - Are people properly trained? - How could someone be killed? - Is there poor housekeeping such as obstacles or - How could people be injured? clutter or torn or slippery flooring or sharp objects? - What may make people ill? - Are there emergency procedures required?

How might these injuries happen to people? What are the special hazards? Broken bones, eye or hearing damage, strains, sprains, What occurs only occasionally, for example, during cuts or abrasions, burns, poisoning or needle-stick injury. maintenance and other irregular work? The SAFE@WORK UOW homepage also provides information on Assessing Risk (via the Risk Matrix) and Implementing Risk Controls by using the ‘hierarchy of controls’, which includes Eliminate, Substitute, Isolate, Engineer, Administrative and Personal Protective Equipment. In some cases activities may require a risk assessment to be completed to ensure risk controls are in place – if the need is identified this should be discussed with the host organisation and Regional Contact.

INCIDENT REPORTING DURING PLACEMENTS Students must refer to the UOW Hazard and Incident Reporting Guidelines, and take the following steps in the event of an incident or near miss. a) Follow Incident Management / WHS protocols of the facility where the incident has occurred. b) Contact your Regional Contact (Jenny Deura, Leanne Betts, or Alice Campbell-Jones) to advise the details of the incident. c) Contact the WHS Unit at the University of Wollongong (UOW) as soon as practicable during business hours on telephone (02) 4221 3931 to report the incident and have a ‘Safety-Net’ report completed in the UOW system. d) The Curriculum Manager will manage the incident via the UOW ‘Safety-Net’ reporting system, and will then liaise with the student and appropriate staff to take corrective action and minimise future risk.

INFECTIOUS DISEASES, SCREENING AND VACCINATION AND HAND HYGIENE Students will have direct contact with patients during placements so there is the potential for transmission of infectious diseases from patients to students or from students to patients. The NSW Health Department requires that students comply with the Policy Document PD2011_005: Occupational Assessment, Screening & Vaccination Against Specified Infectious Diseases, regarding infectious diseases screening and vaccination to minimise the risk of infectious disease transmission in health care facilities. The UOW Policy for managing Blood-Borne Viruses is available at http://www.uow.edu.au/about/policy/UOW160571.html

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ETHICAL AND LEGAL ISSUES

ATTENDING CLINICAL AREAS WHILE UNWELL It is unprofessional to expose patients to the risk of infection. Students scheduled for a clinical round whilst unwell should consider the welfare of those with whom they will be in contact. If in doubt, seek the advice of staff.

INFECTIOUS DISEASES GUIDELINES, TIPS AND TRICKS By student request, we have included this section in your handbook. One of the previous infectious diseases specialists has his own website at www.boutlis.com that is generally accessible within the hospitals. It has links to various guidelines, policies, checklists, teaching materials, and musings about how to live your life as a doctor. Columns are presented in alphabetical order and there are quick links to helpful things like GFR calculators and UpToDate. Please note that the University does not specifically endorse the content of the website and that it is headed by a disclaimer to use it at your own risk.

INSURANCES AND INDEMNITY UOW insurance policies relating to clinical placements include: Student Personal Accident Insurance, along with General and Products Liability Protection and Professional Liability Protection. These policies cover all staff, academic or otherwise, along with students undertaking curriculum-based activities during the GSM academic year. (where students are involved in placements outside of these periods they must investigate their own cover). For further information and to access all relevant polices please refer to the UOW Insurance website: http://www.uow.edu.au/services/finance/index.html.

LEGAL ISSUES In preparation for, and during, Phase 2 you will be required to complete, and sign, a range of forms. Please be mindful that these are legally binding documents and that by signing them, you confirm that they are complete, correct and that you agree with what they contain. If any of these are not the case, do not sign: seek advice.

QUALITY ASSURANCE AND EVALUATION

COURSE EVALUATION AND FEEDBACK The GSM will continue to evaluate the MBBS course in Phase 2. We do not want to over-burden you with evaluation, and we greatly appreciate the time and care you take with this process. The GSM is always looking for ways to ‘close the loop’ on feedback so that staff and students are aware of the actions resulting from evaluation and feedback activities.

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STUDENT ASSESSMENT

Throughout Phase 2, there will be Formative and Summative assessments. Please refer to the GSM Assessment Handbook, available on the eLearning Space for more information.

ASSESSMENT DATES AND DEADLINES The main assessment activities and the deadlines for submission are summarised in Appendix A. There will be an opportunity for students who are required to re-submit or re-take assessments to do so before the start of Phase 3. POEMs, critical analyses and PPD reflections must be submitted on the due date, otherwise penalties or sanctions may apply.

FORMATIVE ASSESSMENT (taken from the GSM Assessment Handbook)

Formative assessments provide students with early feedback on their strengths and weaknesses while learning is taking place. It is our undertaking that before a summative assessment, students will have an opportunity for a similar formative assessment so that both assessors and students are aware of the academic requirements and standards. Formative assessments closely match summative assessments so that students are prepared for the nature and style of the summative assessments, and receive feedback before summative decisions are made. Formative assessment may be either compulsory or non-compulsory

WRITTEN FORMATIVE ASSESSMENTS (Examples: RCA essays, PPD reflections and P-formulary assignments) Written formative assessments provide students with an opportunity to obtain feedback on the quality and standard of their work prior to undertaking a summative written task. Written formative assessments are not compulsory, however, unless students are highly confident in their skills in these areas they are highly recommended. A student’s decision to not submit a written formative assessment will not be held against them.

CLINICAL FORMATIVE ASSESSMENTS (Examples: CEX-s, clinical clerkings, case discussions/ write-ups, self-reflection on history taking) Clinical formative assessments provide students with an opportunity to obtain feedback on their performance in a clinical setting from an experienced preceptor or academic. This opportunity is invaluable to the development of the clinical competency required in our graduates therefore clinical formative assessments are a compulsory course requirement.

The grades obtained and the feedback given in formative clinical assessments are for the students information and do not feed into the final gradebook.

Engagement and active participation in clinical formative assessments forms part of the student performance review (SPR). Failure to engage in clinical formative assessments may result in the student being awarded an unsatisfactory grade in an SPR or be awarded a final subject grade of unsatisfactory.

SUMMATIVE ASSESSMENT (taken from the GSM Assessment Handbook)

Summative assessments provide a measure of student performance against the expected standard and determine progression through the course. Summative assessments are used to determine the final student grade for the subject. Therefore all summative assessments are compulsory. Note: progression requires a grade of ‘Satisfactory’ or above be achieved for all summative assessments.

GRADING All in-course summative assessments will be graded using the following classification scheme. (E) - Excellent (S) - Satisfactory (U) - Unsatisfactory

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STUDENT ASSESMENT

ASSESSMENT BOOKLET Each rotation you will be provided with a Phase 2 Assessment Booklet to complete for that Rotation. You are to use the Assessment Booklet for all SPR’S and CEX-S and they WILL NOT be accepted if they are completed on individual sheets of paper. This booklet is to be handed into GSM professional staff based at the hospitals by Friday of the last day of the rotation. In the event of you misplacing the booklet, please see GSM professional staff based at the Hospitals, you will be required to complete a Statutory Declaration before staff will consider reissuing you with an additional assessment book. Be mindful to use the correct form for the correct activity: SUMMATIVE assessments MUST be completed on the SUMMATIVE CEX-S assessment form. DO NOT use the Summative assessment forms for Formative activities.

CLINICAL EXAMINATION- STUDENT (CEX-S) You are required to complete 2 summative and 5 formative CEX-S per Phase 2 rotation in the Phase 2 Assessment Booklet. One Summative CEX-S must be completed by the end of week 3 of the rotation. The second Summative CEX-S must be completed during weeks 4 or 5 of the rotation. All CEX-S MUST be completed and handed in your Assessment booklet by the last day of the 5 week rotation. You are to contact the Professor or Academic Leader of the specialty should you receive an unsatisfactory grade so that remediation can commence and a resit time discussed. Should the Professor or Academic Leader not be available, please contact the Chair of Phase 2. You will be entitled to ONE resit opportunity per summative CEX-S. Please see the Assessment Handbook for a detailed flow chart. Summative CEX-S must be completed by a Registrar or above

CEX TOPICS

Below are the details relevant to each specific rotation. CEX-S are to be completed on the topics nominated in each speciality i.e. Medicine, Surgery, Child and Adolescent Health, Mental Health and Women’s and Maternal Health.

MEDICINE Two summative CEX-S per Medicine rotation in the presence of the Assessor are required. You must cover all four of the listed compulsory topics by the end of your second Medicine rotation i.e. you do two during your first Medicine rotation and then the other two during your second medicine rotation. During your medicine rotations you will need to do the following summative CEX-S: 1. Perform a cardiovascular exam 2. Perform a respiratory exam 3. Perform a neurology exam either of cranial nerves OR of the peripheral nervous system 4. Examination of the abdomen focusing on medical conditions Options for formative CEX-S include:  ISBAR handover  interpreting a medication chart including medication reconciliation  examination of the diabetic patient  examination of the patient with suspected malignancy  examination of the thyroid  examination of the joints and skin  assessment of cognitive function  interpretation of arterial blood gasses

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STUDENT ASSESSMENT

SURGERY Two summative CEX-S per Surgery rotation in the presence of the Assessor are required. You must cover all four of the listed compulsory topics by the end of your second Surgery rotation i.e. you do two during your first Surgery rotation and then the other two during your second Surgery rotation. During your surgery rotations you will need to do the following summative CEX-S: 1. Examination of the surgical abdomen 2. Assessment of fluid and electrolyte balance on a patient 3. Handover of the post-operative patient 4. Examination of the legs in a surgical patient for peripheral vascular disease OR venous diseases of the legs OR neurological deficit Other options for formative CEX-S include:  pre-operative preparation of a patient  analgesia in a surgical patient  post-operative wound care  obtaining informed consent from a surgical patient  prophylaxis for infection control OR respiratory  pressure area prophylaxis/ care plan and pressure ulcer management plan  DVT risk assessment and prophylaxis plan including the fitting of TEDs and i/op compression stockings  examination of a patient with a fracture  examination of a patient with a hernia  examination of a patient with breast disease  interpretation and discussion of a pathology report from a surgical specimen  insertion of a per urethral indwelling urinary catheter (IDC)

WOMEN’S AND MATERNAL HEALTH During your W&MH rotation you will need to do two summative CEX-S as nominated below in the presence of the Assessor: 1. Perform speculum examinations 2. Perform an examination of a pregnant abdomen in the presence of a doctor. Options for formative CEX-S include:  Take and present an gynaecological history  perform bimanual examinations under anaesthetic  take and present an obstetric history  interpret a CTG *  assist in a major operation  assist in labour *  assist in caesarean section  assist with perineal repair * * denotes CEX-S may be completed by a midwife.

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STUDENT ASSESSMENT

CHILD AND ADOLESCENT HEALTH During your Child and Adolescent Health rotation you will need to do two summative CEX-S as nominated below in the presence of the Assessor: 1. Examination of a child 2. History of a child Options for formative CEX-S include:  History of a child  Examination of a child  Examination of a new born (if not undertaken in the summative)  Counselling of a child or parent It is the student’s responsibility to ensure the situation, examiner and conditions are appropriate to undertake the CEX-S and meet the specified requirements.

MENTAL HEALTH During the MEDI602 Mental Health rotation, each student must complete 2 summative CEX-S assessments on the topics below in the presence of the Assessor.

During your Mental Health rotation you are required to complete the following summative CEX-S: 1. Risk assessment and presentation of findings 2. Mental status examination and presentation

Options for formative CEX-S include:  Focussed drug and alcohol assessment and presentation of findings  Focussed assessment of patient’s current level of functioning  Focussed elicitation of psychotic symptoms and presentation of findings  MSE with a focus on assessment of mood & affect and presentation of findings  Brief psychiatric history and presentation of findings  Cognitive assessment and presentation of findings  Risk assessment and presentation of findings  Mental status examination and presentation

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STUDENT ASSESSMENT

CORE CLINICAL COMPETENCY Assessment of core competencies will continue during Phase 2 during clinical skills time. In addition, clinical skills will feature in the OSCE as part of the end-of-phase examination.

STUDENT P- DRUG FORMULARY You will continue to develop your student P-Drug Formulary during Phase 2 and there are formative assessments based on it. You are expected to complete 1-2 drug formulary templates per week (see Appendix N) and submit them for marking to Mr Lou Gaetani. Please make sure you complete item 13 - the writing of the prescription. Once you have obtained 3 excellent scores you only need to submit one P-Drug Formulary template per month for assessment but you should continue adding 1-2 per week to your personal formulary. Like the log, the formulary builds a longitudinal picture to help you understand what you know and where you need to focus your future learning on drug therapy. We encourage you to use the National Prescribing Curriculum (NPC) online modules (see Appendix W). Please note that some Universities have this as a summative portion at their final exam. At the completion of Phase 2 all students will receive their individual spreadsheet detailing all completed and marked PDSF’s. Your P-Formularies are to be emailed to [email protected]. Please use the template located on Moodle in the Assessment Folder.

END-OF-ROTATION STUDENT PERFORMANCE REVIEW The opportunity for your preceptor to comment on your Personal and Clinical performance has been embedded in a form that also provides feedback about other aspects of your clinical performance during the rotation. The Student Performance Review will be completed for each rotation (Appendix M). This is a summative assessment of your global professional behaviour.

PPD REFLECTIONS You will be required to submit three PPD reflections: one each during rotations 2, 4 and 6. Refer to Appendix O for the PPD Portfolio Reflection Assessment Process.

RCA THEME Research and Critical Analysis skills developed through Phase 2 should be utilised throughout the Phase with your regular attention to asking questions and seeking accurate information to support your learning in evidence based medicine. To aid further development of these skills two summative assignments are to be completed: A POEM (Patient-Oriented Evidence that Matters) and a critical analysis of a drug advertisement. A formative drug advertisement session will be conducted as an on-campus activity. Instructions and topics for the POEM and the marking template are included in Appendix Q - W.

MEDICAL SCIENCES Medical Sciences teaching will be in the format of large-group teaching sessions and GOALs during the on-campus days in 2016, and mainly in the format of GOALs associated with the CBL cases in 2016. The acquired knowledge and its application will be assessed through formative quizzes and in the summative end-of-phase examination.

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STUDENT ASSESSMENT

END-OF-PHASE EXAMINATION The exam week (“IPWE”) is shown on the year planner available on your eLearning space. You are required to be available for exams from Saturday, 27th May until Saturday, 3th June inclusive. The end-of-phase examination will occur during this week and will include formats that are familiar to you – multiple choice best-of-five, extended matching questions and modified essay questions. There will also be an OSCE (objective structured clinical examination) that will test your knowledge and performance in clinically-oriented scenarios. You have already encountered an OSCE-IN Phase 1. Students will be informed of their grades as soon as possible; this is generally 1 week after the final written examination. The end-of-phase examination is integrated and will cover all four themes: Medical Sciences, RCA, PPD and Clinical Competencies. Topics will be drawn from the learning activity outlines of the on-campus activities and the problem blueprints, which in turn link to your clinical activities on your rotations.

STUDENT ACADEMIC CONSIDERATION, STUDENT COMPLAINTS PROCESS AND PROGRESSION For all absences in Clinical Placements and Clinical Skills, applications for Student Academic Consideration in relation to any assessment tasks are submitted using the relevant application form available online via Student Online Services (SOLS).

In all cases, you must apply BEFORE the due date otherwise the extension will not be granted (exemptions can apply, such as being hospitalised). This means that in the case of assignments, for example, as per the GSM Assessment Policy, tasks handed in late will be graded as Unsatisfactory. Approval will only be granted if it falls within the Academic Consideration Guidelines (medical grounds, compassionate grounds or extenuating circumstances). You may appeal against a decision or action affecting your academic performance and/or academic experience by using the GSM Student Complaints and Grievance Process. Decisions about progression to Phase 3 will be made by the Board of Examiners after review of all aspects of your performance in MEDI602. Please refer to the GSM Assessment Handbook, available on your eLearning space.

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STUDENT SUPPORT

HEAD OF STUDENTS Name: Dr Louise Wright Address: Graduate School of Medicine Building 28, Room G09 Phone: +61 2 4221 4907 Facsimile: +61 2 4253 4838 Email: [email protected]

Consultation times: Dr Wright will usually be on campus all day Mondays and Wednesdays, Friday mornings 8:30 - 1:30pm for Head of Students duties. Consultations will also be held at Shoalhaven Campus every second Monday (in Session 1, other Session TBA.) If face-to-face meetings are difficult to arrange due to remote placement from campus, meetings can be arranged by telephone or by email. The Head of Students at the Graduate School of Medicine provides students with advice and information on many aspects of the University Rules and Regulations as well as information relating to their degree. Appointments should be made directly with the Head of Students through email or telephone. The Head of Students has responsibility for but is not necessarily limited to: reviewing and monitoring the progress of all students within the GSM; information and referral for counselling of students, guidance or referral for students whose results and/or progress towards a degree are not satisfactory; liaising, as appropriate with the Dean of Medicine on matters related to students; exercising such delegations as the Council may from time to time determine; mediating where differences arise between students and academic units. The Head of Students can assist students with course and subject advice as well as providing information on UOW and GSM Policies & Procedures.

STUDENTS WITH DISABILITIES The Medical Deans of Australia and New Zealand have developed a guidance document regarding the Inherent requirements for the study and practice of medicine; this is available to GSM students via http://smah.uow.edu.au/content/groups/public/@web/@smah/@med/documents/doc/uow205013.pdf If you have concerns about your ability to meet the inherent requirement please contact the Head of Students. If you have a disability or condition which may adversely affect your studies please discuss the issue with the Head of Students or Student Support Adviser (Jenny Walsh). See also the University’s Disability Services website, http://www.uow.edu.au/student/services/ds/index.html

STUDENT CLEARANCE FOR CLINICAL PLACEMENTS According to the NSW Department of Health Policy Directive - PD2008_029, anyone who enters a NSW Public Health facility as an employee or in any other capacity must first undergo a criminal record check. The system where this is collected and monitored is called ClinConnect. At commencement of the UOW MBBS all students were issued with a National Criminal Record Check. For more information, visit http://www.health.nsw.gov.au/careers/student_clearance/pages/default.aspx. Students are required to notify the NSW Department of Health if they become the subject of a serious allegation or are charged or convicted of any criminal offences during the duration of their course.

MATERNAL AND WOMEN’S HEALTH MILEAGE REIMBURSEMENT In order to assist students attending Bowral and Shoalhaven with travel expenses during the 5 week Maternal and Women’s Health Rotation in Wollongong Hospital, a travel subsidy of $30 per return trip ($150 per rotation group) is available to the allocated driver/s (allocated driver to be decided by the group as car-pooling is required). A Phase 2 Student Mileage Reimbursement Claim Form is available on your Moodle site. Each student claiming needs to fill out a Claim Form. This form needs to be signed by the Bowral or Shoalhaven Placement Facilitator then submitted via email to Rural Student Payments and Subsidies [email protected] or fax: 4221 4341.

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STUDENT SUPPORT

REGISTRATION OF MEDICAL STUDENTS AND NOTIFICATION OF IMPAIRMENT From March 2011, all students enrolled in an accredited medical course approved by the Medical Board were registered by the Board. Individual students do not need to do anything to become registered. There is no fee for student registration. The Australian Health Practitioner Regulation Agency (AHPRA), which supports the Board, worked directly with educational providers to source the names of all medical students now listed on the Register of Students. This Register is not publicly available. The role of the Board in relation to medical students is limited by the Health Practitioner Regulation National Law Act (the National Law) as in force in each state and territory. The Board has no role to play in the academic progress or behaviour of students. The Board’s role is limited to registering students and dealing with notifications about students whose health is impaired to such degree that there may be risk to the public or when the student is found guilty of an offence punishable by imprisonment for 12 months or more. For details and updates regarding guidelines for mandatory notification, information can be found at the Medical Board of Australia. Information regarding student registration can be found on the Board’s website at www.medicalboard.gov.au under accreditation. (Source of this information: Medical Board of Australia)

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STUDENT ACCOMMODATION: WOLLONGONG

STUDENT ACCOMMODATION GUIDELINES: WOLLONGONG UOW operated facilities are utilised for Wollongong students. Campus East: http://www.uow.edu.au/about/accommodation/residences/campuseast/overview/index.html

RESERVATION OF ACCOMMODATION Any student from the Shoalhaven (the Shoalhaven region is determined as south of Kiama) who wishes to be considered for accommodation in Wollongong must contact the Clinical Placements Assistant, Tracy Metcalfe [email protected], as soon as possible. Accommodation is limited and potentially not all students who request accommodation will get it. Subsidised accommodation will be provided to students with a home address in the Shoalhaven. The GSM is not able to provide any accommodation subsidy for students who chose to reside outside of Illawarra/ Shoalhaven regions.

COST OF ACCOMMODATION Students are required to pay $85/week = $425.00 per rotation or $45/week = $225.50 per rotation if a genuine receipt is produced showing that rent or mortgage payments for the term is being paid elsewhere. This must be an official receipt or letter from your estate agency or bank institution. These documents must be given to the Clinical Placements Assistant, Tracy Metcalfe prior to the accommodation placement.

PROCESS  Students who have previously “booked” accommodation will be contacted by the GSM at least 3 weeks prior to the commencement of the next rotation. Students will be required to respond and indicate their accommodation intentions within 7 days of that notification. Failure to respond within this time frame will result in your booking be cancelled. Please note that it is the student’s responsibility to check SOLS and emails for this information and to respond accordingly.

 Each accommodation option requires slightly different paperwork; this will be sent to you by the Clinical Placement Assistant.

 Should you then subsequently cancel your booking with less than 10 working days notice (unless there are compelling circumstances) you will be charged the full cost of the accommodation, which is $225 per week for the full 5 weeks.

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STUDENT ACCOMMODATION: SHOALHAVEN

STUDENT ACCOMMODATION GUIDELINES: SHOALHAVEN The GSM currently has access to leased local accommodation for medical students during Phase 2 rotations. All properties are within a short drive to the hospital and the Nowra CBD. Please contact the Shoalhaven Clinical Placement Office [email protected] for property details.

COST OF ACCOMMODATION Students are required to pay $85/week = $425.00 per rotation or $45/week = $225.50 per rotation if a genuine receipt is produced showing that rent or mortgage payments for the term is being paid elsewhere. This must be an official receipt or letter from your estate agency or bank institution These documents must be shown to the Shoalhaven Clinical Placement Staff or emailed to gsm-placements- [email protected] on arrival or within 48 hours for discount to be given.

FORM OF APPLICATION Any student who requires accommodation at Shoalhaven Hospital must contact the GSM Clinical Placement Office – Shoalhaven, [email protected] to reserve a bed. Beds are limited.

CHECKING INTO ACCOMMODATION From 10.00 am on the first day of the rotation. Further information will be given at the Rotation Orientation or emailed to you prior if the rotation commences with an on-campus day.

VACATING THE RESIDENCE You must vacate your room by 9.00 am on the last Friday of your rotation. Your room will be inspected and if it is found to be left in what is considered an unreasonable order a penalty may be charged.

HOUSEKEEPING ARRANGEMENTS Students will be advised of housekeeping arrangements (i.e. garbage bin collection night etc.) by the Placement Facilitator. Failure to comply with these housekeeping duties may result in a cleaning fee being charged to the student/s.

VISITORS Overnight visitors are NOT permitted in the accommodation provided by the University. If it is found that a guest/s are staying at the premises the student and their guest will be asked to leave the property.

MAINTENANCE Report any faults, damage or problems to the Placement Facilitation Office via [email protected] or calling 4429 1504

SECURITY The GSM is not responsible for students’ personal belongings. Please obtain independent advice in regards to insuring personal items that will be kept at the premises.

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STUDENT ACCOMMODATION: SOUTHERN HIGHLANDS

STUDENT ACCOMMODATION GUIDELINES: SOUTHERN HIGHLANDS The GSM has constructed furnished accommodation at 105 Bowral Street, Bowral (5 x 4 bedroom townhouses) for the purpose of providing accommodation for students during Phase 2 and Phase 3 placements. The allocation of accommodation will be based upon the needs for particular rotations but, generally, Phase 2 students will be allocated a room in 1 of 2 or 3 units.

APPLICATION FOR ACCOMMODATION Before moving into the University provided accommodation, each student must complete an Accommodation Agreement. Copies of the Accommodation Agreement can be found on the GSM’s Online Learning Environment under Course Information / Phase 2 and returned to Placement Facilitator within 7 days of moving into residence.

COST OF ACCOMMODATION Students are required to pay $85/week = $425.00 per rotation or $45/week = $225.50 per rotation if a genuine receipt is produced showing that rent or mortgage payments for the term is being paid elsewhere. This must be an official receipt or letter from your estate agency or bank institution Note: Accommodation fees may be amended in line with any adjustments that occur for accommodation provided In Wollongong. Lodging of an Accommodation Application and payment of fees should be arranged through the Clinical Placement Facilitator. Alice Campbell-Jones Clinical Placement Facilitator Southern Highlands Phone: 02 4861 1571 Email: [email protected]

CHECKING INTO ACCOMMODATION Students starting at Bowral will be able to collect their keys on the first Monday campus teaching day of the rotation, or during the orientation session in Bowral on the Tuesday.

CHECKING OUT OF ACCOMMODATION Students will be required to be out of the accommodation by 5.00pm on the last Friday of their rotation. Keys should be returned to the Clinical Placements Facilitator, Southern Highlands. Rooms will be inspected and if found to be left in what is considered an unreasonable order, the cost of cleaning may be charged to the student.

ROOM KEY No key deposit is required; however, lost or late return of keys will incur a charge of $80. If you require emergency access due to locking yourself out, contact the GSM office during office hours. A master key swipe copy is available to be collected from Bowral District Hospital Accident & Emergency reception if required after-hours.

CAR PARKING Student accommodation is situated in residential areas. Students are asked to be mindful about the impact that car movements and parking will have on the adjoining neighbours. Where possible, students must use the on-site parking area available or rely on street parking.

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STUDENT ACCOMMODATION: SOUTHERN HIGHLANDS

FACILITIES AND HOUSEKEEPING ARRANGEMENTS The house has a well equipped kitchen to allow for self-catering. Students are required to keep the kitchens tidy. Dishes must not only be washed up but also dried and put away, ensuring worktops and sink unit are kept free from clutter. Students are required to supply their own dishwashing detergents, scourers and tea towels. Crockery, cutlery and cooking utensils are provided. Garbage must be disposed of in a safe and hygienic manner and bins must be put out on garbage night. Laundry facilities are equipped with a washing machine, iron and ironing board. Students will need to provide their own washing powder. Resident’s bedrooms contain basic furniture including a bed, wardrobe/hanging space desk, chair and lamp. You are required to provide your own sheets, pillowcases blankets and towels. Bathrooms and common rooms are shared facilities and must be kept clean and neat. Furniture is not to be moved within the house. Residents are responsible for keeping their room and the common areas clean and tidy. A vacuum cleaner is available and should be used. Spills must be mopped up and old outdated foods must be discarded. Residents must remember to take all their food with them upon check-out. Residents are not permitted to stick posters on the walls, or do anything that will cause damage to the surface. If you do wish to put up a poster, use the pin-board provided. Alternatively, bring photo frames and put on the dresser or desk.

UTILITIES The cost of utilities, electricity, gas, water is included in the fees. Students are asked to be sparing in their use of these resources. There is both an environmental and financial cost for wilful overuse. The GSM reserves the right to recover the cost of utilities if it is considered that consumption is excessive.

FIRE AND SAFETY REGULATIONS Smoke detectors have been fitted in the houses. Special care must be taken whilst cooking. Do not leave cooking unsupervised. Smoking is strictly prohibited inside the residences. Please take particular care to ensure that appliances such phone chargers, irons, heaters, hairdryers, etc. are switched off at the power point. A power board with safety cut-off switch may be used for small essential appliances. Double adaptors are not permitted. Food preparation and cooking in bedrooms is strictly prohibited.

MAINTENANCE Students must report any faults, damage or hazard to the Clinical Placement Facilitator as soon as possible so that the matter can be attended to.

IT AND TELEPHONE Wireless internet facilities are available at the houses. Students should try wherever possible to use this access point rather than their 3G network card. The phone provided at each of the houses DOES NOT have the ability to make outgoing calls (except 000), however, calls to University extensions can be made.

SECURITY In the interest of both personal and property security, students must maintain an adequate level of security over the premises at all times. Where security systems are installed these should be switched on when the house is vacant. Students are to check that external doors and windows are secured. Students must not allow unknown persons access to the building (report this to the Clinical Placement Facilitator if this occurs). If a student locks themselves out of their accommodation, they should follow the above procedures for Maintenance.

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STUDENT ACCOMMODATION: CONTACTS

Illawarra Shoalhaven Southern Highlands

Hospital Details The Wollongong Hospital Shoalhaven District Memorial Bowral and District Hospital Crown Street Hospital Mona St, Bowral 2576 Wollongong 2500 Scenic Drive Ph: (02) 4861 0200 Ph: (02) 4222 5000 NOWRA 2541 Ph: (02) 4421 3111 Southern Highlands Private Hospital Bowral St, Bowral, NSW 2576 (02) 4862 9400

Accommodation Tracy Metcalfe Leanne Betts / Liz Melleuish Alice Campbell-Jones Contact Clinical Placement Assistant Clinical Placement Office Clinical Placement Facilitator Block C, Level 8 Bowral and District Hospital Wollongong Hospital Shoalhaven Hospital Ph: (02) 48 611 571 Ph: (02) 4221 3957 Ph: (02) 4429 1504 Mobile: 0432 694 443 Fax: (02) 4253 4835 Fax: (02) 4423 9559 Email: gsm-placements- Email: [email protected] Email: gsm-placements- [email protected] [email protected]

Accommodation University operated 99 Berry Street, Nowra 105 Bowral Street, Bowral Address accommodation: Campus East

Phase 2 GSM accommodation is intended for people who are rotating away for a specific term, with the understanding that a “home” location will be either Wollongong or Shoalhaven.

All accommodation bookings in Phase 2 are for the full 5 weeks.

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APPENDIX A - TIMETABLES OF ASSESSMENTS AND DEADLINES FOR SUBMISSION

Assessment Type Due dates 19th August 2016 (Friday) 23rd September 2016 (Friday) 11th November 2016 (Friday) PPD Student Performance Review Summative 16th December 2016 (Friday) 24th February 2017 (Friday) 31st March 2017 (Friday) 12th May 2017 (Friday) 19th August 2016 (Friday) 23rd September 2016 (Friday) 11th November 2016 (Friday) CEX-S Summative 16th December 2016 (Friday)

24th February 2017 (Friday) 31st March 2017 (Friday) 12th May 2017 (Friday) One before 16th December 2016 (Friday) Nursing Attachment SPR Summative One before 12th May 2017 (Friday)

Clinical core competencies: Summative 19th August 2016 (Friday) Case Presentation

Clinical core competencies: 18th November 2016 (Friday) Summative Pap Smear 21st November 2016 (Monday)

POEM Summative Midnight, 21st August 2016 (Sunday)

PPD reflection: Rotation 2 Summative Midnight, 23rd September 2016 (Friday)

PPD reflection: Rotation 4 Summative Midnight, 16th December 2016 (Friday)

Critical analysis of a drug advert Formative Midnight, 23rd October, 2016 (Sunday)

Critical analysis of a drug advert Summative Midnight, 20th November 2016 (Sunday)

PPD reflection: Rotation 6 Summative Midnight, 31st March 2017 (Friday)

OSCE Formative TBA

OSCE Summative Between Saturday, 27th May and Saturday, 3rd June 2017

End of phase integrated examination Summative Between Saturday, 27th May and Saturday, 3rd June 2017

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APPENDIX B – Phase 2 Key Dates

PHASE 2 KEY DATES

Introduction to Phase 2 11 July 2016 – 15 July 2016

Rotation 1 18 July – 19 August 2016

Rotation 2 22 August – 23 September 2016

Vacation 26 September – 7 September 2016

Rotation 3 10 October – 11 November 2016

Rotation 4 14 November – 16 December 2016

Vacation 19 December 2016 – 20 January 2017

Rotation 5 23 January – 24 February 2017

Rotation 6 27 February – 31 March 2017

Vacation 3 April – 7 April 2017

Rotation 7 10 April – 12 May 2017

Wrap-Up Week 15 May – 19 May 2017

Study Week 22 May – 26 May 2017

Exams 27 May - 2 June 2017

Vacation 6 June – 7 July 2017

Re-sit Examinations will be held prior to commencing Phase 3

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APPENDIX C – Phase 2 On-Campus Dates

PHASE 2 CAMPUS DAYS

INTRO WEEK Monday 11 July - Friday 15 July 2016 Rotation 1 Monday 18 July - Friday 19 August 2016 Friday 22 July

Monday 25 July Friday 5 August Monday 8 August Friday 19 August Rotation 2 Monday 22 August - Friday 23 September 2016 Monday 22 August

Friday 2 September Monday 5 September Friday 16 September Monday 19 September Rotation 3 Monday 10 October - Friday 11 November 2016 Monday 10 October

Friday 21 October Monday 24 October Friday 4 November Monday 7 November Rotation 4 Monday 14 November - Friday 16 December 2016 Friday 18 November

Monday 21 November Friday 2 December Monday 5 December Friday 16 December Rotation 5 Monday 23 January - Friday 24 February 2017 Friday 3 February

Friday 17 February Rotation 6 Monday 27 February - Friday 31 March 2017 Friday 3 March

Friday 17 March Friday 31 March Rotation 7 Monday 10 April - Friday 12 May 2017 Friday 5 May

WRAP UP WEEK Monday 15 May - Friday 19 May 2017

APPENDIX D – Phase 2 On-Campus Days

FORTNIGHT TIMETABLE PHASE 2 SESSION 1 WEEKS 1 – 20 Monday Tuesday Wednesday Thursday Friday

Week A On-campus day 24-32 hours of clinical activities

Week B 24-32 hours of clinical activities On-campus day

TEMPLATE FOR ON-CAMPUS DAYS DURING PHASE 2 SESSION 1 WEEKS 1 – 20 (SUBJECT TO AMMENDMENT)

Time Monday Friday Time 8.30am Lecture 1 8.30am Anatomy Lecture

9.00am (60 mins) 9.00am

(90 mins) 9.30am Lecture 2 9.30am

10.00am (60 mins) 10.00am Break

10.30am 10.30am

11.00am 11.00am CBL Intro Clinical Skills Clinical Skills - Group 1 11.30am Online Group 1 11.30am

12.00pm 12.00pm

12.30pm 12.30pm LUNCH 1.00pm 1.00pm 1.30pm 1.30pm

2.00pm Clinical Skills - Group 2 2.00pm Clinical Skills CBL Intro 2.30pm Group 2 Online 2.30pm

3.00pm Lecture 5 3.00pm

3.30pm Lecture 3 (60 mins) 3.30pm

4.00pm (60 mins) Lecture 6 4.00pm

4.30pm Lecture 4 (60 mins) 4.30pm

5.00pm (60 mins) CBL Feedback 5.00pm Online 5.30pm GOAL 1 - Online

ONLINE

6.30pm GOAL 2 - Online

ONLINE

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APPENDIX E – Phase 2 On-Campus Days Session 2

FORTNIGHT TIMETABLE PHASE 2 SESSION 2 WEEKS 21 - 36 Monday Tuesday Wednesday Thursday Friday

Week A 24-32 hours of clinical activities

Week B 24-32 hours of clinical activities On-campus day

TEMPLATE FOR ON-CAMPUS DAYS DURING PHASE 2 SESSION 2 WEEKS 21 – 36 (SUBJECT TO AMMENDMENT)

Time Friday 8.30am 8.30am Clinical Skills Group A 8.30am

9.00am 9.00am

(2hrs) 9.30am 9.30am

10.00am 10.00am

10.30am Break 10.30am (30 mins) 11.00am Clinical Skills Group B 11.00am

11.30am 11.30am

(2hrs) 12.00pm 12.00pm

12.30pm 12.30pm

1.00pm Break 1.00pm (30 mins) 1.30pm Lecture 1 1.30pm

2.00pm (1hr) 2.00pm

2.30pm Lecture 2 2.30pm

3.00pm (1hr) 3.00pm

3.30pm Lecture 3 3.30pm

4.00pm (1hr) 4.00pm

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APPENDIX F – Learning Outcomes

At the successful completion of the course student will be able to: 1 Integrate knowledge of research and critical analysis principles cohesively within the practice of medicine 2 Demonstrate coherent knowledge of the principles and concepts of medical science within the context of the medical profession 3 Effectively employ evidence based practice, use critical thinking, and perform as a collaborative, reflective practitioner and health advocate 4 Demonstrate clinical competency at the level expected of an intern 5 Display and practice professional and personal behaviour expected of a medical practitioner 6 Integrate knowledge of medical science, clinical medicine, research and critical analysis and professional and personal behaviour into the practice of medicine 7 Meet the qualification requirements to apply for an internship in Australia

MBBS Subject Learning Outcomes Medical Sciences (MS) MS01 The normal structure and function of the body and each of its major organ systems MS02 Molecular, biochemical, and cellular mechanisms that are important in maintaining the body's homeostasis MS03 The relationship between structure and function of cells, tissues, organs and systems MS04 Factors contributing to health and illness and the mechanisms of their influence (pathogenesis) MS05 How structure and function (pathology and pathophysiology) of cells, tissues, organs and systems are altered by diseases and conditions MS06 How common investigative techniques are used to differentiate between normal and abnormal structure and function MS07 Principles of drug absorption, metabolism and excretion; dose response relationships and drug specificity and selectivity with respect to desired actions and side effects MS08 Scientific knowledge and its relation to clinical problems MS09 Limitations to existing scientific knowledge MS10 Relief of pain, amelioration of suffering and optimisation the quality of life of patients MS11 Theories and principles that govern ethical decision making and the major ethical dilemmas in medicine MS12 Principles of human behaviour and development throughout life, and their relationship to health and illness MS13 Identification of factors that place individuals at risk of disease or injury MS14 The manner in which people of diverse cultures and belief systems perceive health and illness and respond to symptoms, diseases, and treatments MS15 The health care needs and social and cultural perspectives of health of Indigenous Australians MS16 The psychological, social, environmental and cultural determinants of health and illness MS17 The importance of recognizing and addressing individual gender, socioeconomic and cultural biases in the delivery of health care MS18 The organization, financing, and delivery of health care in Australia, including the challenges and opportunities for regional, rural and remote communities

Clinical Competencies (CC) CC01 Taking a focused history from the patient, family, friend or carer to determine the nature of the patient’s problems and identify possible causes CC02 Conducting complete mental state examination or appropriate components in a systematic and directed fashion CC03 Conducting a complete physical examination or appropriate components in a systematic and directed fashion CC04 Making an accurate assessment of the patient’s problems and formulating a differential diagnosis based on the history and examination findings CC05 Selecting, ordering and interpreting appropriate initial investigations for the presenting problem

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APPENDIX F – Learning Outcomes

CC06 Recording, evaluating and interpreting data from history, physical examination and diagnostic investigations and developing a provisional diagnosis CC07 Making a diagnosis, constructing therapeutic strategies for patients with common conditions, developing and implementing a management plan CC08 Monitoring the effectiveness of a patient management plan and modifying that plan in response to the ongoing acquisition of information CC09 Contributing to cure of or recovery from illness and the easing of suffering and discomfort CC10 Utilizing strategies for health promotion and prevention of disease and disability in encounters with patients CC11 Establishing, building and maintaining therapeutic partnerships with patients, their family, friends, and carers CC12 Communicating, both verbally and in writing, with patients, patients’ families, colleagues, and others with whom physicians must share information in carrying out their responsibilities CC13 Working as a member of health care teams CC14 Dealing compassionately with patients, heir family, friends and carers CC15 Identifying potential danger to self and others taking appropriate action to limit impact CC16 Openness to acknowledging one's own limitations and knowing when to seek advice or assistance CC17 A patient-centred approach to patient care CC18 Respect for the role and function of all those involved in patient care, and the ability to collaborate with them CC19 Optimization of patient comfort, dignity and privacy in all clinical encounters CC20 Obtaining informed consent and knowing where the responsibility for obtaining consent lies in all aspects of investigation, treatment and management CC21 Preparing patient for, explaining and conducting technical and practical procedures CC22 Making thorough and accurate observations, measurements and calculations and recording assessment data in a manner that is legible, organized, concise and accurate CC23 Recognising immediately life-threatening conditions, demonstrating effective decision making and instituting appropriate initial therapy

Personal and Professional Development (PD) PD01 A questioning approach to own work and that of others PD02 Maintenance of patient confidentiality and knowledge of legislative exceptions PD03 Receptiveness and responsiveness to change PD04 An ethical approach in all aspects of professional life, including the demonstration of honesty, integrity, reliability and dependability, a non-judgmental approach and a commitment to patients, society and the profession PD05 Utilisation of the best practice guidelines and requirements of professional and regulatory bodies PD06 Adopting teaching and learning roles in interactions with colleagues, patients and their families PD07 Fulfilling professional responsibilities in both work and external contexts PD08 Seeking and taking advantage of opportunities to undertake lifelong learning PD09 Sensitivity and responsiveness to patients’ culture, age, gender and disabilities PD10 Applying self-reflection and critical self-evaluation to professional practice PD11 Awareness of one’s own attributes and motivations, the capacity to use that awareness to guide self-care, and the skills to address one’s own interpersonal, psychological and emotional needs PD12 Time and workload management skills such that resources are used effectively and efficiently PD13 The importance of achieving balance within one’s personal and professional life and having strategies to achieve this PD14 Maintenance of proper boundaries in professional practice PD15 Recognizing and dealing with uncertainty and adverse outcomes PD16 The legal responsibilities of medical practice in Australia PD17 Ethical issues associated with human and animal research related to medicine

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APPENDIX F – Learning Outcomes

Research and Critical Analysis (RCA) RCA01 Locating and accessing scientific and clinical information RCA02 Critically evaluating and utilising information for solving problems and making evidence-based decisions relevant to the health of individuals and/or populations RCA03 Continually seeking improved solutions/practices for positive organisational, social and cultural change RCA04 Health services, social determinants of health and the burden of disease RCA05 Appropriately interpret, appraise and use statistics and data RCA06 Recognise appropriate research methods/study design and interpret results RCA07 Setting and testing research hypotheses and/or research question RCA08 Evidence based medicine and clinical guidelines RCA09 Primary, secondary and tertiary prevention of disease

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APPENDIX G – MBBS Clinical Competencies, Skills & Procedures

CLINICAL SKILLS COMPETENCY LEVELS These lists cover the expected level of competence at the end of each Phase of training:  Phase 1 – 18mths mainly preclinical (P1)  Phase 2 – 12mths hospital rotations (P2)  Phase 3 – 12mths community clinical experience (P3)  Phase 4 – 6mths elective and pre internship training in hospitals (P4)  Graduation occurs at the end of Phase 4  Post Graduate years 1 and 2 have been added to the list to indicate the continuum of medical training after graduation (PG1 & PG2) Developed for: University of Wollongong, Graduate School of Medicine, 2012 by Dr Helen Rienits, Co Academic Leader Clinical Skills Sourced from and cross-referenced with:  Australian Curriculum Framework for Junior Doctors  Medical Deans of Australia and New Zealand: ‘Framework of Competencies for Medical Graduate Outcomes’ (Feb 2012)  University of Adelaide Medical School ‘Competency levels’  Current Skills Lists as described for each speciality in Phase 2 rotation handbooks.

Key to Competency Levels Table A* As for level A below and is able to teach the skill to more junior medical students. A Competently and independently performs the skill in the real clinical environment and demonstrates a high level of understanding of the relevant theory and principles. Can independently explain /interpret the principles to a patient in the real clinical environment. Shows others how to perform the skill in a sound manner. Systematically analyses and reflects on their practice. Once level A is achieved it is expected to be maintained. B Performs the skill in the real clinical environment with supervision and demonstrates a high level of understanding of the relevant theory and principles. Competently explains /interprets the principles to a patient in the real clinical environment with supervision. Shows others how to perform the skill in a sound manner. Systematically analyses and reflects on their practice. C Shows how to perform the skill and understands relevant theory and principles. Performs the skill and explains /interprets the principles to a patient in a simulated (or real) clinical setting with guidance and supervision. Constantly reviews their performance and uses a range of sources to reflect on their performance. D Knows how to perform the skill and understands the relevant theory and principles. Is able to explain and/or demonstrate the process and principles with prompting and guidance. Seeks feedback from others when reflecting on their performance of this skill. E Observes the skill and understands the relevant theory and principles. Can reflect on the application of this skill and on feedback given to improve performance. Key to Professionalism Skills PS-A Reliably demonstrates the professional ethic or behaviour required for this skill. Seeks appropriate feedback and demonstrates self-reflection when applying this skill. PS-B Understands the professional ethic or behaviour required for this skill. Able to reflect on the ethic or behaviour required as applied to this skill.

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APPENDIX G – MBBS Clinical Competencies, Skills & Procedures

Core Skill – Communication and History Level of competency at end of Phase (P) or Post Grad Year (PG) SKILL P 1 P 2 P 3 P 4 PG1 PG2 1 Opening and Closing the Interview B A A A* 2 Building the Relationship B B A A* 3 Signposting and Summarising B B A A* 4 Forward Planning Patient Management E C B A A* 5 Explanation and Giving Instructions/Advice E C B A A* 6 Communication with Children E C B B A A* 7 Communication with Adolescents E C B B A A* 8 Communication with the Elderly D C B B A A* 9 Communication with Disabled pts. D C B B A A* 10 Communication with ESL pts. D C B B A A* 11 Communication using Interpreters E E D C B A 12 Culturally Diverse Communication D C B B A A* 13 Breaking Bad News E C C B A 14 Patient Centred Decision Making E C C B A 15 Motivational Interviewing E D C C B A 16 Taking A Full Medical History C B A A* 17 Case Write Up & Medical Records D C B B A A* 18 Case Presentation (Formal) E D C C B A 19 Case Handover (Verbal, ISBAR, etc) E C B B A A* 20 Formulating a Diagnosis & Differential D C B B A A*

Core Skill – Basic Examinations Level of competency at end of Phase (P) or Post Grad Year (PG) SKILL P 1 P 2 P 3 P 4 PG1 PG2 1 Anthropometry Ht, Wt, BMI, WC A A* 2 Vital Signs: Pulse, BP, Temp, RR B A* 3 Cardiovascular System Examination B A A* 4 Peripheral Vascular System Exam. B A A* 5 Respiratory System Examination B A A* 6 Gastrointestinal System Exam. B A A* 7 Renal System Examination C B A* 8 Hydration Assessment C B A* 9 Male Genitourinary System Examination C B B A A* 10 Female Genitourinary System Examination C B B A A* 11 Breast Examination C B B A A* 12 Musculoskeletal System Examination C B B A A* 13 Peripheral Nervous System Examination C B B A A* 14 Cranial Nerves Examination C B B A A* 15 Assessment of Higher Functions D C B B A A* 16 Mental State Examination C B B B A A* 17 Basic Psychiatric Risk Assessment C C B B A A* 18 Head & Neck incl. ENT & Thyroid Examination D C B A A* 19 Assessment of the Diabetic D C B A A* 20 Examination of the Skin C C B A A*

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APPENDIX G – MBBS Clinical Competencies, Skills & Procedures

Core Skill – Basic Procedures Level of competency at end of Phase (P) or Post Grad Year (PG) SKILL P 1 P 2 P 3 P 4 PG1 PG2 1 Hand Hygiene A A* 2 Waste Disposal / OH & S / PPE B A* 3 Basic Life Support (CPR) B A A* 4 Oxygen Therapy & Pulse Oximetry D C B A A* 5 Venipuncture & Blood samples and Cultures D C B A A* 6 Administering Medications – all methods D C B A A* 7 Intramuscular Injections C C B A A* 8 Subcutaneous Injections C C B A A* 9 Performing Basic investigations: U/A, Swabs C B A A* 10 Blood Glucose Testing / Finger Prick C B A A* 11 Insulin Delivery Devices D D C B A A* 12 Airway Management & Devices C C B B A A* 13 Interpret Medication Charts C B B A A* 14 Surgical Scrub & Sterile Fields E D C B A A* 15 Interpret Ward Documentation E C B A A* 16 Record a 12 lead ECG E C B A A* 17 Basic First Aid, Simple Dressings D C B A A* 18 Use of Inhalers, Spacers, Nebulisers E C B A A* 19 Safe Manual Handling for Patient Care C B B A A* 20 Calculating Drug Doses D C B A A*

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APPENDIX G – MBBS Clinical Competencies, Skills & Procedures

Speciality Skill – Emergency Medicine / Critical Level of competency at end of Phase (P) or Post Grad Year (PG) Care & Anaesthetics SKILL P 1 P 2 P 3 P 4 PG1 PG2 1 Insertion IV Cannula E C B A A* 2 Administer / Connect IV Fluids E C B A A* 3 Prescribe IV Fluid Therapy D C B A A* 4 Intravenous Injections and Medications E D C B A* 5 Volume Resuscitation C C B A* 6 Blood Transfusion C C B A A* 7 Massive Transfusion Protocol C C B B A* 8 Advanced Life Support including Defibrillation D C B B A A* 9 Advanced Airway Management D C C B A A* 10 Endotracheal Intubation D C C B A* 11 Nasopharyngeal Aspiration D C B A* 12 Nasogastric Tube Insertion D C B A* 13 Nasogastric and PEG Feeding D D C B A* 14 Care of the Unconscious Patient D C C B A* 15 Cervical Spine Stabilisation E C B A A* 16 Management of Envenomation E D C B B A* 17 Collecting Arterial Blood Gases D C B A* 18 Interpreting Arterial Blood Gases D C B A* 19 Central Venous Lines & Pressure Reading E D C B A 20 Recognising Acute and Deteriorating Patients D C B A A* 21 Femoral Venipuncture D C B A* 22 Post Resuscitation Care D C C B A* 23 Induction of General Anaesthesia E D D C C 24 Nerve Blocks E D D C B 25 Acute Pain Management D C B A A* 26 Chronic Pain Management E C C B B 27 Post Operative Pain Management (Anaes.) D C B A A* 28 Pre Operative Assessment D C B B A* 29 Basic Physiological Monitoring D C B A A* 30 Managing Airway in Unconscious Patient D C B B A A* 31 Ventilation with Bag and Mask D C B A* 32 Understand Principles of Different Anaesthetics D C C B A* & Techniques of Administration 33 Infiltration local Anaesthetic E C B A A* 34 Epidural Anaesthesia E D D C C

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APPENDIX G – MBBS Clinical Competencies, Skills & Procedures

Speciality Skill – General Medicine Level of competency at end of Phase (P) or Post Grad Year (PG) SKILL P 1 P 2 P 3 P 4 PG1 PG2 1 Assessment of Nutrition / Diet C B B A A* 2 12 Lead ECG Interpretation E C B A A* 3 Examination of the Abnormal Heart D C B B A* 4 Perform Spirometry & Peak Flow E C B A* 5 Interpretation of Spirometry E D C B A* 6 Interpretation of X rays esp. Chest & Abdomen E C B A A* 7 Basic Interpretation of CTs, U/S, MRI, BMD, E C B A A* Nuclear Scans, etc. 8 Anticoagulant Therapy E D C B A A* 9 Insulin Therapy E D C B A A* 10 Pleural Tap / Peritoneal Tap & Drainage E D C B A* 11 Lumber Puncture & CSF Measure E D C B A* 12 Bone Marrow Biopsy E D C B A* 13 Stress ECG / Echocardiogram / Holter monitor E D C B B 14 Perform Cardiac Risk Assessment C B B A A* 15 Perform DVT Risk Assessment D C B A A* 16 Endoscopy E D D C 17 Colonoscopy / Sigmoidoscopy E D D C 18 Interpretation Pathology Results E D C B A A*

Speciality Skill – Obstetrics & Gynaecology Level of competency at end of Phase (P) or Post Grad Year (PG) SKILL P 1 P 2 P 3 P 4 PG1 PG2 1 Bimanual Pelvic Examination E C C B A* 2 Taking PAP Smears & Thin Prep D C B B A* 3 Female Urinary Catheter Insertion & Removal C C B A A* 4 Antenatal Assessment & Obstetric Examination C C B B A* 5 Postnatal Assess. Incl. Depression Screening C C B B A* 6 Interpretation CTG D C B A A* 7 Obstetric & Gynaecological History Taking D C C B A* 8 Contraception Counselling D C B B A A* 9 Investigating the Infertile Patient E D C C B A 10 Pregnancy Testing & Counselling re results E D C B B A* 11 Normal Vaginal Delivery E D C B A* 12 Assisted delivery –Forceps/Vacuum E D D C B 13 Management Normal Labour E D C B A* 14 Rhesus Negative Management D C B A* 15 Normal Third Stage Labour Management D C B B A* 16 Breast Feeding Advice E D C B A* 17 Pelvic Floor Assessment D C B A A* 18 Collecting Urethral, Cervical and Vaginal C B B A* Swabs 19 Initial Management Obstetric Emergencies D C C B B

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APPENDIX G – MBBS Clinical Competencies, Skills & Procedures

Speciality Skill – Surgery & Orthopaedics Level of competency at end of Phase (P) or Post Grad Year (PG) SKILL P 1 P 2 P 3 P 4 PG1 PG2 1 Digital Rectal Examination C B B A A* 2 Prostate and Male Genitalia Exam C B B A A* 3 Male Urinary Catheter Insertion and Removal C B B A A* 4 Examination for Hernia D C B A* 5 Acute Wound Assessment D C B A* 6 Wound Closure & Basic Suturing E D C B A* 7 Chronic Wound/Ulcer Assessment D C B A A* 8 Application Simple Dressings E D B A A* 9 Post Operative Management (Surgical) D C B A A* 10 Burns Assessment & Dressings D C C B A* 11 Removing Sutures and Staples C B A* 12 Trauma Assessment and Management D C C B A 13 Chest Drain Insertion & Management E C C B B 14 Suprapubic Bladder Tap/Cath E C C B B 15 Handling Specimens Appropriately D B A A* 16 Fine Needle Aspiration Biopsy D C C B A 17 DVT Prevention D C B A* 18 Proctoscopy D C B A A* 19 Head Injury Management E D C C B A* 20 Diagnosis of Breast Ca and Referral E D C B A A* 21 Emergency Limb Stabilisation E C B A A* 22 Therapeutic Limb Stabilisation D C B A A* 23 Application of Splints,Slings, Bandages Strapping D C B A A* 24 Application of Plaster of Paris C B A A* 25 Removal of Plaster of Paris C B A A* 26 Application Lower Limb Traction D C B A A* 27 Indications Joint Replacement/ Arthroscopy D C B B A A* 28 Joint Aspiration and Injection D C C B A*

Speciality Skill–Advanced Procedural & Diagnostics Lvl of competency at end of Phase (P) or Post Grad Year (PG) SKILL P1 P2 P 3 P4 PG1 PG2 1 Insertion of Pacemaker E E D D D 2 Cardioversion E D D C 3 Peritoneal and Haemodialysis E E D D C 4 Renal Biopsy E E E D D 5 Liver Biopsy E E D D D 6 Bronchoscopy E E D D D 7 Coronary Angiography and Stents E E D D D 8 Transoesophageal Echocardiogram E E D D D 9 PEG Insertion E E D D C 10 PICC line/Portacath/ Hickman Insertion E D D C 11 Doppler Vascular Studies. E E D C C

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APPENDIX G – MBBS Clinical Competencies, Skills & Procedures

Speciality Skill – Psychiatry & Mental Health Level of competency at end of Phase (P) or Post Grad Year (PG) SKILL P 1 P 2 P 3 P 4 PG1 PG2 1 Mental State Examination E D B B A* 2 Psychiatric History Taking D C B A A* 3 Psychotic Patient Interview E D C B A A* 4 Depression Screening D C B A A* 5 Use of Relaxation Therapy D C B A A* 6 Involuntary Detention Orders D C B A* 7 ECT Therapy E D C B B 8 Management Teen Depression D C B B A 9 Use of Depression Scoring Systems D C B A* 10 Drug and Alcohol Abuse Assessment D C B A* 11 Managing Challenging Behaviour D C B A A* 12 Case Management Planning D C B A A* 13 Suicide Risk Assessment D C C B B A* 14 Prescribing Psychoactive Drugs E D D C B

Speciality Skill – Child and Adolescent Health Level of competency at end of Phase (P) or Post Grad Year (PG) SKILL P 1 P 2 P 3 P 4 PG1 PG2 1 Well Baby & Newborn Checks D B B A* 2 Assessment of Development D C B B A 3 Adolescent HEADSS Assessment D C B A A* 4 Paediatric Immunisations E D C B A* 5 Assessment Growth & Nutrition D C B A A* 6 Examining the Sick Child D C B A A* 7 Infant Feeding E D C B A* 8 Allergies and Food Intolerance D C B A A* 9 Apgar Score C C B A* 10 Foreskin Care /Circumcision Indications D C B B A* 11 Paediatric Blood Pressure Management E D C B B A 12 Newborn Screening Tests E D C B A* 13 ORT in Young Children D C C B A* 14 Management Newborn Jaundice E D C C B 15 The Febrile Child & Febrile Seizures E D C B A* 16 Collection Specimens in Children E D C B A*

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APPENDIX G – MBBS Clinical Competencies, Skills & Procedures

Speciality Skill – General Practice & Community Level of competency at end of Phase (P) or Post Grad Year (PG) SKILL P 1 P 2 P 3 P 4 PG1 PG2 1 Vaccination Schedules (Incl. Travel, E D C B A A* Immunotherapy, Adult Immunisations) 2 Writing a Prescription & the PBS C B A A* 3 Authority and SP Prescriptions D C B A A* 4 Diagnose Death & Completion Certificates D C B A A* 5 Coroner’s Court Referral D C B A* 6 Sickness & Workcover Certificates C B B A* 7 Referral Letters / Discharge Letters E C B A A* 8 Ordering Pathology/Radiology, etc. E C B A A* 9 Interprets Standard Test Reports E D B A A* 10 Appropriate Specimen Handling E D B A* 11 Cold Chain Maintenance E C B A* 12 4yr/ 45yr/ 75yr Age Health Assessments D C B A A* 13 Needle Aspirations – cysts, etc. D C B A* 14 Chronic Disease Management E D C C B A 15 EPC plans, TCAs& Dental Care Plans D C C B A* 16 Lifestyle Advice Management E D B A A* 17 CDM Case Conference D C B A A* 18 Asthma Management Plans E D C B A* 19 Medication Home Reviews/ Polypharmacy D C B A* 20 Interpret Post Mortem Examination Reports D C B A A* 21 Advance Care Planning/ Guardianship Plans D C B A A* 22 ‘Not For Resuscitation’ Decisions/Counselling E D C B A* 23 Presents and Defends Clinical Reasoning E C B A A* 24 Mental Health Care Plans & Referrals E D C B A A* 25 Age & Sex Appropriate Screening Tests for E D C B A A* General Public 26 Professional Behaviour/ Ethics PS-B PS-B PS-A 27 Cultural & Spiritual Aspects of Patient Care PS-B PS-A 28 Indigenous Cultural Awareness PS-B PS-B PS-A 29 Concept of Duty of Care PS-B PS-A 30 Community Emergency and “Good Samaritan” PS-B PS-B PS-A Care/ Laws 31 Manages Uncertainty PS-B PS-B PS-A 32 Able to Apologise to a Patient PS-B PS-B 33 Concept of Interdisciplinary Teamwork PS-B PS-B PS-A 34 Confidentiality and Privacy Laws PS-B PS-A 35 Concept of Professional/ Patient Boundaries PS-B PS-B PS-A

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APPENDIX G – MBBS Clinical Competencies, Skills & Procedures

Speciality Skill – ENT/Ophthalmology/Dermatology Level of competency at end of Phase (P) or Post Grad Year (PG) SKILL P 1 P 2 P 3 P 4 PG1 PG2 1 Ear Toilet & Syringing, Ear Wick Insertion E C B A* 2 Use of Auroscope / Examine External Ear D C B A A* 3 Use of Tuning Forks/ Assess Hearing Loss, D C B A* 4 Interpretation Audiometry D C B A* 5 R/O Foreign Body from Ears and Nose D C C B A* 6 Management of Epistaxis & Nasal Packing D C C B A* 7 Use of Thudicum (Nasal Speculum) D C B A* 8 Indirect Laryngoscopy E E D D C 9 Initial Management Dental Abscess D C B B A* 10 Examination of Eye & Lid Eversion E D C B A A* 11 Simple R/O Foreign Body from Eyes & Padding E D C B A A* 12 Visual Field and Acuity Testing E C B B A* 13 Application of Eye Drops D C B A* 14 Use of Ophthalmoscope E D B B A* 15 Use of Slit Lamp E C B A A* 16 Removal skin FBs & Biopsy Skin Lesion D C B A* 17 Use of Dermatoscope E D C B A

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APPENDIX H – Nursing Attachment Learning Activity Outline

Learning Activity Outline: Hospital Nursing Attachment, Phase 2 Working with nurses—partners in health care delivery Logistics: Each student will have to make their own arrangements directly with the Nurse Preceptor on a hospital ward, for one shift during Phase 2: session 1 (first 6 months) and one shift during Phase 2: Session 2 (second 6 months). We recommend completing this during Surgery or Medicine rotations. Learning Activity Facilitator: Registered nurse in hospital ward Learning Outcomes: By the end of the nursing attachment, students should: 1. be able to explain the role of registered nurses in hospital in-patient care, and how nurses communicate with patients and other health care professionals 2. be able to explain how the ‘nurse handover’ facilitates continuity of patient care 3. have undertaken or assisted with basic patient care activities, where appropriate and under nurse supervision 4. have appraised systems that nurses use to safely administer medications in the hospital setting (identifying the potential for support or compromise of quality and safety in patient care). Assumed Knowledge: By the time of the nursing attachment experience in Phase 2, students will have completed Phase 1, comprising a series of ‘blocks’ in the major body systems, where the theory that underpins medical practice has been presented in the context of common clinical presentations in these systems (e.g. chest pain in CVS block). This has been complemented by related sessions in the Clinical Skills Centre, and general practice and hospital placements. The latter enabled students to practice communication and physical examination skills in the real world of clinical practice. In the Skills Centre, students will have performed basic procedures such as obtaining informed consent, BP and TPR assessment, venipuncture, giving injections, and using the new medication chart (MR70). With patient consent, and close supervision, students may practice basic procedures during the nursing attachment. Relevance to Medical Practice: As quality and safety in patient care relies on effective communication between health care workers, patients and their family/friends/carers, medical students need opportunities to understand the role and responsibilities of nurses, and build relationships with them, as they are key partners with doctors in delivering patient care. Orientation to a workplace such as the hospital ward is also relevant for ‘would be’ medical practitioners to foster understanding of the role the system may play in quality health care and/or adverse advents. This placement will enable students to also examine the important issue of ‘medicating safely’ in the hospital environment, from the nurse perspective. Learning Activity Overview: Each medical student will associate with a registered nurse for 2 full shifts: one at the start of Phase 2 (session 1), and one at the start of year 3 (session 2). S/he will work with this nurse for 2 shifts, according to their assigned nurse’s roster. The registered nurse will liaise with students to provide the following student learning activities: 1. Observation of an individual nurse carrying out their professional roles in the hospital and participating where appropriate, in nurse to nurse handovers, or team meetings about patient care 2. Under the supervision of assigned nurses, performance of basic patient care activities, such as recording and monitoring vital signs, giving injections, assisting with wound care, or intravenous therapy 3. Documentation of performance elements that nurses use to prevent wrong site, wrong procedure or wrong patient treatment 4. Appraisal of ‘medicating safely’ systems used in the hospital ward, identifying procedures or activities that foster or compromise patient safety Learning Activity Resources: Hospital medication chart (MR70), Ward resources in relation to the ‘nurse to nurse patient handover’ and safe medication practices. Key questions for student during/after the attachment: What is the daily routine of a hospital ward? How do nurses contribute to patient care in the hospital setting, and how does their role differ to that of doctors? How may nurse-doctor communication be modified for improved patient outcomes? What is the patient’s perspective on the holistic care nurses provide? What can patients (when an inpatient) do to improve the quality and safety of their hospital-based health care? What do nurses do to ensure that they have the correct patient at the time of providing a service? What are potential causes of medication errors during hospital-based care? What key learning issue in relation to this nursing placement needs further exploration? Pre-readings: National Patient Education Framework, Section 7, Specific issues: Preventing wrong site, wrong procedure and wrong patient treatment; and Medicating safely, pp. 255-271 Assessment: At the end of each nursing attachment, the student’s supervisor will complete Section B of the Student Performance Review form, to provide feedback on the student’s personal and professional behaviour during the attachment. Each student should record key events or learning experiences that occurred during the placement, in their clinical log. Such events or experiences may form the basis of a subsequent portfolio reflection written assessment task.

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APPENDIX I – Nursing Attachment SPR

Student Performance Review – Nursing Attachment MEDI602 – Summative Assessment To be completed by the Nursing Preceptor and discussed with the student.

Student Name: ……………………………………………………………………….. Date: …..…/…….../………

Nursing Placement – Ward and Hospital ………..…………………………………………………………………………………

Part A: Preceptor rating of student engagement

Instructions: please rate the level of student engagement in the following four activities.

Unsatisfactory Satisfactory Excellent Observed Not i. Observation of an individual nurse carrying out their professional roles in the hospital and participating where appropriate, in nurse to nurse handovers, or team meetings about patient     care ii. Under the supervision of assigned nurses, performance of basic patient care activities ON A NOMINATED PATIENT, such as recording and monitoring vital signs, giving injections,     assisting with wound care, or intravenous therapy iii. Documentation of performance elements that nurses use to prevent wrong site, wrong     procedure or wrong patient treatment iv. Appraisal of ‘medicating safely’ systems used in the hospital ward, identifying procedures or     activities that foster or compromise patient safety

Overall level of student performance

 Unsatisfactory  Satisfactory  Excellent

Preceptor Name: …………………………………………………………. Designation: ………………………………………………………… (please PRINT)

Signature: ………………………………………………………….. Date: …………/………/…………… Ph: …………………………………

Part A: Student Response Student Comments:

Student Signature: ……………………………………………………………….. Date: …………/………/………… Ph: ……………………

Part A: Academic Coordinator Signoff Academic Coordinator Signature: ……………………………………………………………….. Date: …………/………/…………… Ph: ……………………………

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APPENDIX J – Phase 2 Book List

PHASE 2 BOOK LIST Medicine: Papadakis, M, McPhee, S & Rabow, M 2016, Current Medical Diagnosis and Treatment 2016, McGraw Hill, New York.* Quinn, G, Gleason, N, Papadakis, M & McPhee, S 2016, Current Medical Diagnosis and Treatment Study Guide, McGraw Hill, New York.* Rang, H, Ritter, J, Flower, R & Henderson, G 2016, Rang and Dales Pharmacology, 8th edn, Elsevier, Edinburgh. *

Surgery: Euliano, TY & Gravenstein, JS 2011, Essential Anesthesia: from Science to Practice, 2nd edn, Cambridge University Press, Cambridge. * Tjandra, J, Clunie, G, Kaye, A & Smith, J 2006, Textbook of Surgery, 3rd edn, Blackwell Publishing, Malden Mass.* Ramachandran, M & Gladman, MA 2011, Clinical Cases and OSCEs in Surgery, 2nd edn, Churchill Livingstone, Edinburgh. Sadler, TW 2014, Langman’s Medical Embryology, 13th edn, Lippincott, Williams & Wilkins, Philadelphia.

Child and Adolescent Health: Cameron, P 2011, Textbook of Paediatric Emergency Medicine, 2nd edn, Elsevier Churchill Livingstone, Edinburgh.* Harris, W 2011, Examination Paediatrics, 4th edn, Elsevier, Chatswood.* Kane, K 2009, Colour Atlas and Synopsis of Pediatric Dermatology, 2nd edn, McGraw Hill, New York. South, M & Isaacs, D (eds) 2012, Practical Paediatrics, 7th edn, Churchill Livingstone/Elsevier, Edinburgh.*

Metal Health: Bloch, S & Singh, BS (eds.) 2007, Foundations of Clinical Psychiatry, 3rd edn, Melbourne University Press, Carlton. Buntting, B. 2011, Nuts and Bolts of Psychiatry, Buntting Books, Queensland. Castle, DJ & Bassett, D 2013, A Primer of Clinical Psychiatry, 2nd edn, Churchill Livingstone, Chatswood, NSW.* Katona, C.L.E., Cooper C & Robertson M. 2016, Psychiatry at a Glance, 6th edn, Wiley-Blackwell, Oxford.*

Obstetrics and Gynaecology: Magowan, B, Owen, P & Drife, J (eds) 2014, Clinical Obstetrics and Gynaecology, 3rd edn, Saunders Elsevier.*

General reference books: Breen, KJ, Cordner, SM, Plueckhahn, VD & Thomson, CJH 2010, Good Medical Practice: Professionalism, Ethics and Law, Cambridge University Press, Cambridge. * Epstein, O, 2008, Clinical Examination, 4th edn, Mosby, Edinburgh. * Goering, RV (ed.) 2013, Mims’ Medical Microbiology, 5th edn, Mosby, St Louis. * Kumar V, Abbas AK, Aster J (2012) Robbins Basic Pathology, 9th edn, Elsevier* Kumar, P & Clark, M (eds.) 2012, Kumar & Clark’s Clinical Medicine, 8th edn, Elsevier/Saunders, Edinburgh.* (9th edition 2016 on order, not yet published) Silverman, J, Kurtz, S & Draper, J 2013, Skills for Communicating with Patients, 3rd edn, Radcliffe Publishing, Oxford. Talley, N & O’Connor, S 2014, Clinical Examination: a systematic guide to physical diagnosis, 7th edn. Churchill Livingstone/Elsevier, Sydney. *

* Denotes that these texts are available online via the UOW Library

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APPENDIX K –Summative CEXs Form

Clinical Examination–Student (CEX-S) MEDI602 – Summative Assessment

Student Name: ______Student No: ______

Assessor Name: ______

Practice/Hospital: ______

Patient Problem/Diagnosis: ______

Discipline Students must complete all compulsory topics listed below - see pages 3 and 4 of booklet for more details (tick 1 box only) Cardiovascular Respiratory Neurology examination of cranial Examination of the abdomen focusing on Medicine     examination examination nerves OR the PNS medical conditions Examination of legs in a surgical patient for Examination of the Handover of the Assessment of fluid and Surgery     peripheral vascular disease OR venous diseases surgical abdomen post-operative patient electrolyte balance of a patient of the legs OR neurological deficit Women’s and  Speculum examination  Examination of a pregnant abdomen Maternal Health Paediatrics  Examination of a child  History of a child

Mental Health  Risk assessment and presentation of findings  Mental status examination and presentation

CEX-S Assessment Time Setting Case Complexity  Low Observation time (mins): ______ Inpatient  Outpatient  Moderate Feedback time (mins): ______ Primary Care  Other  High

Not PLEASE TICK APPROPRIATE JUDGEMENT Unsatisfactory Borderline Satisfactory Excellent Observe (see page 28 of booklet for detailed guidelines) d History Taking Skills      Examination Skills      Communication Skills      Professional Skills      Clinical Judgement      Procedural Techniques / Skills     

Overall clinical competence Unsatisfactory Satisfactory Excellent in relation to stage of training    Comments (particularly required if grade is unsatisfactory, but feedback is valuable for all students)

Assessor Consultant / Registrar Signature: ………………………………………………………………… (Circle the one that applies) Date / /

Student Signature: ………………………………………………………………… Date / /

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APPENDIX L – Formative CEXs Form

Clinical Examination–Student (CEX-S) MEDI602 – Formative Assessment

Student Name: ______Student No: ______

Assessor Name: ______

Practice/Hospital: ______

Patient Problem/Diagnosis: ______

CEX-S Assessment Time Setting Focus Case Complexity Discipline  Inpatient  History  Low  Medicine Observation  Outpatient  Examination  Moderate  Surgery time (mins): ______ Primary Care  Communication  High  Paediatrics  Other  Diagnosis  O&G Feedback  Procedure  Psychiatry time (mins): ______ Chronic Care

PLEASE TICK APPROPRIATE JUDGEMENT Not (see page 28 for detailed guidelines) Unsatisfactory Borderline Satisfactory Excellent Observed History Taking Skills      Examination Skills      Communication Skills      Professional Skills      Clinical Judgement      Procedural Techniques / Skills     

Overall clinical competence Unsatisfactory Satisfactory Excellent in relation to stage of training    Comments (particularly required if grade is unsatisfactory, but feedback is valuable for all students)

Assessor Signature: ………………………………………………………………………………………….. Date: / /

Student Signature: …………………………………………………………………………………………. Date: / /

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APPENDIX M – Student Performance Review Form

Student Performance Review (SPR) MEDI602 – Summative Assessment To be completed by the preceptor and discussed with the student.

Student Name: ______Date: _____/______/______

Placement (e.g., Rotation/Session): ______

PART A: Interaction with Student Preceptor Instructions: Please indicate the amount of time you have spent interacting with the student during the current rotation/session/performance period Occasions spent with student per week:  0 - 1  2 - 3  4 - 5  5 - 6  7 or more

PART B: Evidence of clinical activity Preceptor Instructions: The student is to present ALL Clinical Examination (CEX-S) and Clinical Log summaries completed during the current rotation/session/performance period. Preceptor to review the CEX-S forms and Clinical logbook summaries and complete the following:

Number of CEX-S forms Number of patients Range of  Unsatisfactory completed: recorded in Clinical Log: patients seen:  Satisfactory

PART C: Rating of student performance

Preceptor Instructions: Consider all aspects of the student’s performance observed by

yourself or your colleagues throughout the performance period and provide both a rating for each behaviour (i – ix) and an overall judgement.

Unsatisfactory Unsatisfactory Borderline Satisfactory Excellent NotObserved i. History taking skills      ii. Examination skills      iii. Communication skills      Ability to effectively exchange information with supervisors, colleagues and patients. iv. Professional boundaries / Sensitivity to patients Maintains appropriate boundaries with supervisors, colleagues, and patients.      Shows respect and discretion with all patients regardless of culture, age, gender or disability

v. Teamwork / Attendance Maintains cooperative working relationships, promoting positive group interaction.      Participation across learning opportunities throughout the performance review period. vi. Resilience / Flexibility Ability to bounce back from professional and personal set-backs.      Ability to reprioritize tasks and duties as necessary. vii. Sharing knowledge / Seeking help Participates in a collaborative educational role with supervisors, colleagues, and patients.      Identifies own limitations and seeks appropriate advice or assistance as necessary.

vii. Ethical and legal standards      Applies ethical and legal standards in all professional situations. ix. Clinical decision making / Knowledge base Ability to analyse, synthesise and interpret information to form appropriate clinical decisions.      Demonstrates appropriate knowledge and understanding of relevant medical sciences and clinical skills.

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APPENDIX K – Student Performance Review Form

Part D: Preceptor Feedback for Student

Please list a minimum of 2 student strengths:

Please list a minimum of 2 areas that need attention:

If you are unable to list student strengths and weaknesses, please explain why

Part E: Preceptor Recommended Grade

Recommended Grade

 Unsatisfactory  Satisfactory  Excellent (Note: a grade of 'excellent' or 'unsatisfactory' requires supportive explanation. Please provide a justification in the space below.)

Preceptor Consultant / General Practitioner / Registrar (circle the one that Name: applies) (please PRINT)

Signature: Date: / / Ph:

Part F: Student Response Student comments:

Student Signature: Date: / / Ph:

Part G: Final Grade (To be determined by the Academic Coordinator. Note: If the final grade is to be changed this must be discussed with the Preceptor.)

 Unsatisfactory  Satisfactory  Excellent

Academic Coordinator Signature: Date: / / Ph:

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APPENDIX N – Student P-Drug Formulary

Phase 1 In assigned CBL groups, students will complete a number of P-drug student formularies (PDSF).

Phase 2 As individuals, students will complete one/two PDSF’s per week on patients that students have seen, with the view of completing 120 PDSF’s by the end of Phase 4.

At the completion of Phase 2 all students will receive their individual spreadsheet detailing all completed and marked PDSF’s. Your P-Formularies are to be emailed to: [email protected].

Treatment of common medical conditions This list will be of help to you as you see patients and think about their conditions and treatment - it acts as a guide - it is not intended that you should learn about all the drugs listed here - see the Core Drug List and concentrate on learning about those drugs numbered 1. A number of drugs have been highlighted on the Core Drug List to draw your attention to the pharmacological principles that you will learn by reading about these drugs. The disease states, drugs and 93 problems have also been loosely matched. The drug list chosen include all but 10 of the top 100 most prescribed drugs on the Australian PBS.

Therapeutic Classes 93 Problems Cardiovascular Disease  Hypertension 56 Hydrochlorothiazide, metoprolol, verapamil, amlodipine, ramipril, irbesartan, prazosin  Angina 47 GTN, isosorbide dinitrate, metoprolol, verapamil, diltiazem, amlodipine, aspirin  Myocardial Infarction/Acute Coronary Syndromes 46, 47 Morphine, alteplase, aspirin, clopidogrel, unfractionated heparin (UFH) \enoxaparin, metoprolol, ramipril  Heart Failure 50, 54, 57, 59 Frusemide, ramipril, carvedilol, digoxin, spironolactone, irbesartan, metoprolol  Atrial Fibrillation 55 Digoxin, aspirin, warfarin, sotalol, amiodarone  Other arrhythmias 46, 47, 55 Adenosine, verapamil, amiodarone, atropine  High Blood Cholesterol 47 Atorvastatin, ezetimibe, fenofibrate  Venous Thromboembolism 48, 51 Unfractionated heparin (UFH) \enoxaparin, warfarin, vitamin K, rivaroxaban Respiratory Disease  Asthma 17, 59 Salbutamol, salmeterol, fluticasone, ipratropium, cromoglycate, prednisolone, montelucast  Anaphylaxis 38, 46, 59 Adrenaline (epinephrine), hydrocortisone, oxygen, promethazine  Respiratory Failure 50, 57 Oxygen, assisted ventilation  Pneumonia 49, 57 Amoxycillin (amoxicillin), azithromycin/doxycycline, ceftriaxone, gentamicin, metronidazole  Chronic Obstructive Airways Disease 57, 59 (as asthma and respiratory failure +) trial of steroids, home oxygen  Tuberculosis 49, 51, 57 Rifampicin, isoniazid, ethambutol, pyrazinamide,

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APPENDIX N – Student P-Drug Formulary

Gastrointestinal Tract  Nausea and Vomiting 18, 72 Metoclopramide, domperidone, ondansetron  Peptic Ulcer Disease (including helicobacter) 62, 67, 69 Ranitidine, pantoprazole, metronidazole, amoxicillin, clarithromycin  Chronic Diarrhoeas/Inflammatory Bowel Disease 60, 61, 62, Prednisolone (enemas+oral), sulphasalazine, mesalazine, azathioprine, infliximab 64,66,71  Constipation 60, 61, 62, 64, 65 Bran (bulk-forming), senna (stimulant), lactulose (osmotic laxative)  Liver Failure and Ascites – Alcohol withdrawal 34, 54, 60, 68, 70 Vitamin B, pantoprazole, spironolactone, diazepam  Overdoses 2, 16, 17, 20, 22, When to perform gastric lavage, activated charcoal; paracetamol & N- 24, 28, 34, 46, 52, acetylcysteine, benzodiazepines & flumazenil, opiates & naloxone, salicylates & 55, 70, 72 diuresis, amitriptyline & cardiac monitoring Gynaecology & Urinary Tract Disease  Urinary Tract Infection 74, 76, 80, 83, 85 Trimethoprim, amoxycillin, cephalexin, norfloxacin  Oral Contraceptives 73, 79 Combined oestrogen (synthetic)-progestogen [ethinyloestradiol-norethisterone], progestogen only pill  Hormone Replacement Therapy 79 Oestradiol (natural)  Stimulate the Uterus Oxytocin 82 Central Nervous System  Anxiety/Depression 30, 31, 32, 36 Diazepam, amitryptiline, sertraline, venlafaxine,  Psychoses/Mania 16, 20, 34 Chlorpromazine, haloperidol, lithium, risperidone  Drugs for Dependence 28 Nicotine, methadone  Pain 04, 06, 09, 10, 11, Paracetamol, ibuprofen, codeine, morphine, oxycodone 14, 19,23,37  Epilepsy 17, 23, 24 Carbamazepine, valproate, clonazepam, lamotrigine, levetiracetam, phenytoin, phenobarbitone  Parkinson's Disease 15, 22 L-dopa-carbidopa combination, selegiline, benzhexol, bromocriptine, apomorphine  Migraine 19, 21 Paracetamol, ergotamine, metoclopramide, sumatriptan, (prophylaxis-propranolol, amitriptyline)  Meningitis 16, 21 Benzyl penicillin, ceftriaxone, ampicillin, vancomycin Metabolic & Endocrine Disorders  Diabetes Mellitus 85, 89,90, 91 Gliclazide, metformin, short-, intermediate- and long-acting insulins, pioglitazone, sitagliptin  Diabetic Comas 91 Glucagon, potassium, saline, low-dose insulin infusion  Thyrotoxicosis and Hypothyroidism 07, 89, 90 Carbimazole, propranolol, thyroxine [levothyroxine]  Adrenal insufficiency 52, 92 Hydrocortisone, fludrocortisone

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APPENDIX N – Student P-Drug Formulary

Musculoskeletal & Joint Disease  Arthritis 10, 11 Paracetamol/Ibuprofen, diclofenac  Rheumatoid Arthritis 11 Paracetamol/Ibuprofen, prednisolone, sulphasalazine, hydroxychloroquine, methotrexate, gold, infliximab, etanercept  Gout 11, 9 Diclofenac, allopurinol, probenecid, colchicine  Osteoporosis and bone protection during corticosteroid use 9, 10 Calcium supplements, vitamin D, alendronate Infections  Urinary Tract Infection 74, 76, 80, 83, 85 Trimethoprim, amoxycillin, cephalexin, norfloxacin  General and respiratory tract infections 06, 43, 45, 49 Amoxycillin (amoxicillin), azithromycin, ceftriaxone, gentamicin, metronidazole, doxycycline,  Meningitis 16, 21 Benzyl penicillin, ceftriaxone, ampicillin, vancomycin  HIV 06,08,12 Efavirenz + zidovudine + lamivudine (treatment is complex and updated regularly, see http://www.ashm.org.au/aust-guidelines/)  Sepsis/PID Aerobic and Anaerobic 37,60,80 Gentamicin, vancomycin, ceftriaxone, metronidazole, Anaesthesia  Providing Local Anaesthesia 13,14 Lignocaine  Principles of General Anaesthesia

AMH Home > Chapter 2 - Anaesthetics > General anaesthetics

Prescription Writing Guidelines

AMH Home > Guide to prescribing

 Core knowledge and practice

Not covered in PDSF

10 of the top one hundred Pharmaceutical Benefits Scheme list relating to Eyes/Skin/Vaccines; and other very specialised drugs used in oncology are not included and will be covered in other areas of learning.

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APPENDIX N – Student P-Drug Formulary

CORE-DRUG LIST Key 1. Commonly used - need to know about these 2. Less commonly used 3. Rarely used or specialist drugs

Drug Pharmacological Principle Notes 1. adrenaline (epinephrine) 1 different strength/drug calculations 2. allopurinol 1 (enzyme inhibition) 3. alteplase 1 (evidence based medicine, - clinical trials having an immediate effect on medical practice) 4. amitriptyline 1 (overdose,anti-cholinergic side effects, autonomic pharmacology) 5. amlodipine 1 6. amoxycillin [amoxicillin] /ampicillin 1 (allergy) 7. aspirin 1 (anti-imflammatory, analgesic and anti-platelet mechanisms) 8. atorvastatin 1 9. atropine 1 10. azithromycin 1 11. benzyl penicillin 1 12. benzhexol 1 13. calcium 1 14. carbamazepine 1 rash 15. carbimazole 1 16. ceftriaxone 1 17. cephalexin 1 18. chlorpromazine 1 19. clarithromycin 1 20. clopidogrel 1 21. clozapine 1 (pro-drug) 22. codeine 1 (pro-drug) 23. cromoglycate 1 24. diazepam 1 (active metabolites) 25. diclofenac 1 increased risk MI – NSAIDS 26. digoxin 1 (loading and maintenance dosing, renal disease, age, toxicity, clinical response) 27. diltiazem 1 28. doxycycline 1 secondary use – malaria 29. ethinyloestradiol/norethisterone= 1 (risk versus benefit, multiple sites of progestogen only OC action) 30. fenofibrate 1 31. flumazenil 1 32. fluticasone 1 33. furosemide 1 34. gentamicin 1 (therapeutic drug monitoring - through blood concentrations)

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Drug Pharmacological Principle Notes 35. gliclazide 1 36. glucagon 1 37. glyceryl trinitrate (GTN) 1 38. haloperidol 1 tardive dyskinesia 39. unfractionated heparin (UFH) 1 HITTS \enoxaparin 40. hydrochlorothiazide 1 (flat dose-response curve) 41. hydrocortisone 1 42. ibuprofen 1 (analgesia) 43. insulin 1 high incidence of errors 44. ipratropium \ tiotropium 1 (cholinergic receptors) 45. irbesartan 1 46. isosorbide mononitrate 1 tolerance 47. lactulose 1 use in hepatic encephalopathy 48. L-dopa/carbidopa 1 (monitoring therapy) 49. lignocaine 1 50. lithium 1 (monitoring therapy, toxicity) 51. metformin 1 52. methadone 1 use in narcotic dependence 53. metoclopramide 1 EPS in young 54. metoprolol 1 (adrenergic-receptors, agonism and antagonism, beta-selectivity, lipid and water solubility, compare with propranolol) 55. metronidazole 1 56. morphine 1 “allergy” 57. N-acetylcysteine 1 antidotes 58. naloxone 1 antidotes 59. nicotine 1 need QUIT programme 60. oestradiol 1 61. oxycodone 1 62. oxygen 1 63. oxytocin 1 64. pantoprazole 1 65. paracetamol 1 (overdose with antidote, analgesia) 66. phenytoin 1 (zero-order kinetics, teratogenicity, drug interactions, toxicity, therapeutic drug monitoring) 67. prazosin 1 first dose hypotension 68. prednisolone 1 complications of use 69. prochlorperazine 1 EPS in young 70. promethazine 1 71. ramipril 1 (enzyme inhibition monitoring response) 72. ranitidine 1 73. rifampicin 1 (enzyme induction and inhibition) 74. risperidone 1 75. salbutamol 1 (adrenergic receptors, agonism and antagonism, beta-selectivity) 76. salmeterol 1

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Drug Pharmacological Principle Notes 77. senna 1 78. sertraline 1 serotonin syndrome 79. sitagliptin 1 80. spironolactone 1 81. sulphasalazine 1 82. thyroxine [levothyroxine] 1 83. trimethoprim 1 84. valproate 1 85. vancomycin 1 86. venlafaxine 1 87. verapamil 1 (ionic channel blocker, pharmacodynamic interaction with beta-blockers) 88. vitamin B 1 89. vitamin D 1 90. warfarin 1 (dosing and monitoring strategies, drug interactions) 91. adenosine 2 92. alendronate 2 93. amiodarone 2 94. azathioprine 2 95. carvedilol 2 96. clonazepam 2 97. colchicine 2 98. domperidone 2 99. etanercept 2 100. ethambutol 2 101. fludrocortisone 2 102. hydroxychloroquine 2 103. infliximab 2 104. isoniazid 2 105. lamivudine 2 106. montelucast 2 107. norfloxacin 2 108. ondansetron 2 109. phenobarbitone 2 110. pioglitazone 2 111. probenecid 2 112. selegiline 2 113. sotalol 2 114. sumatriptan 2 115. zidovudine 2 116. apomorphine 3 117. bromocriptine 3 118. efavirenz 3 119. methotrexate 3 120. pyrazinamide 3

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APPENDIX N – Student P-Drug Formulary

DEVELOPING YOUR OWN P-DRUG STUDENT FORMULARY (PDSF)

Questions to ask yourself about patients' drugs

One of your main chances to learn about drugs occurs while you are doing clinical work. Asking yourself the questions below will help you to learn more systematically from this experience. If you cannot answer them for yourself, discuss them those who are treating the patient.

1. NAME: For each drug listed, what is the approved or generic name?

2. CLASS: To what class does each drug belong (e.g. diuretic, phenothiazine)?

3. AIM: What aim is to be achieved with each drug: What disorder of function is to be corrected, or what symptom relieved?

4. MECHANISM OF ACTION: What is the mechanism of action of the drug? How does the drug work for the condition or symptom being treated?

5. ALTERNATIVES: What other remedies might have been chosen instead of the drug? Is it a good choice? Consider efficacy, safety, cost.

6. ROUTE AND DOSAGE: By what route, in what dose and at what intervals is each drug to be given, and why? In what form(s) does the drug come?

7. OBSERVATIONS: What observations can be made to judge whether the aim has been achieved? When should they be made and by whom?

8. DURATION: How long should treatment go on, and when and how could a decision be made to stop?

9. ELIMINATION: How is the drug eliminated? Will the patient's illness change the usual pattern of distribution and effects of the drug?

10. UNWANTED EFFECTS: What undesirable effects may occur from this drug? Are they acceptable? What is their approximate frequency?

11. INTERACTIONS: Are there any other drugs which should be avoided while the patient is receiving this treatment? If yes, which are they and why should they be avoided?

12. PATIENT'S IDEAS: What are the patients perceptions of their disease state and the drug treatment of it. Does s/he need additional information with regards to the medications to increase compliance and reduce side effects.

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APPENDIX N – Student P-Drug Formulary

Student name: Site where patient seen: Date:

1. NAME OF DRUG: What is the approved or generic name?

2. CLASS: To what class does each drug belong (e.g. diuretic, phenothiazine)?

3. AIM OF TREATMENT: What aim is to be achieved with the drug: What disorder of function is to be corrected, or what symptom relieved?

4. MECHANISM OF DRUG ACTION: What is the mechanism of action of the drug? How does the drug work for the condition or symptom being treated?

5. ALTERNATIVE MEDICATIONS: What other remedies might have been chosen instead of the drug? Is it a good choice? Consider efficacy, safety, cost.

6. ROUTE AND DOSAGE: By what route, in what dose and at what intervals is each drug to be given, and why? In what form(s) does the drug come?

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APPENDIX N – Student P-Drug Formulary

7. OBSERVATIONS: What observations can be made to judge whether the aim has been achieved? When should they be made and by whom?

8. DURATION OF TREATMENT: How long should treatment go on, and when and how could a decision be made to stop?

9. Drug ELIMINATION: How is the drug eliminated? Will the patient's illness change the usual pattern of distribution and effects of the drug?

10. UNWANTED EFFECTS: What undesirable effects may occur from this drug? Are they acceptable? What is their approximate frequency?

11. Drug INTERACTIONS: Are there any other drugs which should be avoided while the patient is receiving this treatment? If yes, which are they and why should they be avoided?

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APPENDIX N – Student P-Drug Formulary

12. PATIENT'S IDEAS: What are the patients perceptions of their disease state and the drug treatment of it. Does s/he need additional information with regards to the medications to increase compliance and reduce side effects.

13. MEDICATION CHART: Practice prescribing the drug for your patient by writing up the medication in the copy of the medication chart below.

REGULAR MEDICATIONS

Year 20______Date & Month DOCTORS MUST ENTER administration times

Date MEDICATION (Print Generic Name) Tick if slow release

Route Dose Frequency & NOW enter times

Indication Pharmacy

Prescriber Signature Print your Name Contact

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APPENDIX O – PPD Reflection Assignments

PERSONAL & PROFESSIONAL DEVELOPMENT WRITTEN REFLECTION The PPD Portfolio Reflection Assessment Process During Phase 2, you are required to submit 3 PPD reflections (word limit: 1500 words each). Submission due dates are as follows:  PPD reflection: rotation 2 Summative Midnight, Friday 23 September 2016  PPD reflection: rotation 4 Summative Midnight, Friday 16 December 2016  PPD reflection: rotation 6 Summative Midnight, Friday 31 March 2017 Each PPD Reflection should focus on an event or process that was a significant learning experience or an event that you recognise as significant for your personal or professional development that relates specifically to your Specialist Phase 2 Rotations Your first PPD reflection should focus on an event or process from Rotations 1 & 2; your second Reflection on an event or process from Rotations 3 & 4; and your third Reflection on an event or process from Rotations 5 & 6. Note: Your written reflection should critically review your professional behaviour and personal response, in relation to the event or process you have chosen to write about, against the 9 behavioural domains (items 1-9) listed in the PPD Portfolio Reflection Assessment Form. To demonstrate that you meet the academic standards of the MBBS, you must also pay close attention to the way in which you address items 10-13 in the PPD Portfolio Reflection Assessment Form. Assignments should be submitted electronically using the relevant e-submission link in the Assessments folder on Moodle. Starting in Phase 2, each assignment is to be submitted electronically via the e-submission link in the Assessment PPD folder on your eLearning Space. Your actual assignment should not contain your name, only your student number in the header of each page so that it can be marked anonymously (markers will not have access to databases that would allow your name to be matched to your student number). Written reflections will be distributed to external markers. External markers will grade your reflections according to the PPD Portfolio Reflection Assessment Form. Grades from external markers will be submitted to internal moderation. You will be notified via your eLearning Space when your graded PPD Portfolio Reflection is available for collection. Your mark will reflect a global assessment of your ability to demonstrate insight, self-awareness and situation analysis, as well as to demonstrate your ability to identify learning goals and the steps you are taking towards achieving them.

What do I do once I receive my graded PPD Portfolio Reflection?  Read the feedback provided by the external markers.  Provide a written response in the space provided (if desired), and sign the form.  Discuss the completed reflection assessment with your mentor (if you are still participating in the GSM Student Mentoring Program).

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APPENDIX P –MEDI602 PPD Reflection Marking Rubric

PPD Reflection assignments will be graded against the 13 criteria listed below. An overall grade of Unsatisfactory, Satisfactory or

Excellent will be awarded based on the marker’s global assessment of the assignment.

Sometimes Notall at Not applicable Marking Criteria Mostly 1. Respect and sensitivity towards patients Shows sensitivity, responsivity, respect and discretion will all patients regardless of culture, age, gender or disability 2. Professional and personal boundaries Maintains appropriate professional boundaries whilst establishing, building and maintaining professional therapeutic relationships. 3. Teamwork Maintains cooperative working relationships and respect for the rights and responsibilities of all team members promoting a positive group interaction 4. Prioritising, punctuality, preparedness Ability to set priorities and meet deadlines including punctual attendance at, and adequate preparation for, teaching sessions.. 5. Professional resilience Manages interpersonal, psychological or emotional situations arising from their professional role. 6. Receptiveness and responsiveness to change Ability to identify shifting priorities, the need for change, and adapt her/his plans or behaviour in response to this need. 7. Learning and sharing knowledge Actively takes a respectful and collaborative educational role in interactions with supervisors, colleagues, patients and their families. 8. Managing uncertainty and seeking help Ability to self-reflect and analyse, synthesise and interpret information, identify her/his own limitations and seek advice or assistance when necessary. 9. Ethical and legal standards Ability to apply ethical and legal standards in all situations. 10 Clear written communication skills Logical and coherent structure along with correct grammar, spelling and appropriate word length 11. Range of evidence to support reasoning and problem-solution Clinical and research evidence to support the analysis, sysnthesis and interpretation of information 12. Clear identification of learning goals and strategies to achieve these goals Appropriate and realistic learning goals as well as ways to achieve those goals. 13 Evidence of action to address learning goals Active implementation of strategies to achieve learning goals.

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APPENDIX Q – RCA Assignment Submission Guidelines

The assignments must be correctly laid out and referenced, citing relevant peer-reviewed literature and databases. Assignments are required to be formatted using the following guidelines. 1. A4 page using double-spaced text with a 3cm left and right margin. 2. Text to be 12 point Times New Roman. 3. A title page with assignment title, your student number and word count (excluding references). 4. Student number only (not student name) as a header or footer on each page. 5. Each page numbered. 6. References, both in-text and reference list, to follow the Author-Date (Harvard) referencing style. (http://www.library.uow.edu.au/referencing/) Requests for special consideration and/or extensions need to be made by the student through SOLS, which can be accessed via the university website.

Submission Assignments should be submitted electronically using the relevant e-submission link in the Assessments folder on Moodle. You may check your assignments for originality by using Turnitin (www.turnitin.com). All assignments will be submitted to Turnitin by the RCA team after submission through eLearning Space. Information on Turnitin can be found at: http://www.uow.edu.au/student/services/ld/staff/UOW022082.html

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APPENDIX R – RCA Summative Assessment Task

WRITE A POEM What is a POEM? POEM stands for “Patient-Oriented Evidence that Matters”. A POEM must be relevant and should meet three criteria:

 It should address a question that is faced by practising doctors or health care professionals.  It should measure outcomes that are important to clinicians and patients: symptoms, morbidity, quality of life and mortality.  It should have the potential to change the way that doctors practise.

Aims This assessment task aims to develop skills in applying critical analysis principles to a source article to attempt to resolve a clinically relevant question. In choosing a source article only systematic reviews which include a meta-analysis are used. The student must perform a valid literature search, recognise high-quality research and analyse and present the findings of the research in a clinically meaningful way. Students are expected to demonstrate critical thinking and evaluation and to use their words for interpretation of the research.

Guidelines to Writing a POEM To write a POEM, students are required to search for an appropriate source article which describes research relevant to the task question. In choosing a source article only systematic reviews which include a meta-analysis are used. Preliminary results or evaluations reporting on intermediate or surrogate outcomes are not usually reviewed. For example, angiographic evidence of coronary artery disease could be used but not its surrogate measure of plasma cholesterol.

A POEM must also be valid. For example, studies of treatments or interventions should be of the highest level possible; that is, randomised, controlled trials. For more information refer to the information on NHMRC evidence hierarchy in Table A of this appendix. For reviews, only systematic reviews that include meta-analyses are considered. The source article selected and the type of evidence required will vary with the clinical question.

Layout of a POEM

1. Indicate the source of your evidence: that is, the title of the article you are using, referencing it in full. (See UOW library for guidance re referencing). Your POEM should use the research from ONE source article only. 2. Clinical Question: Frame the question as one relevant to clinical practice (one sentence). 3. Indicate how / where you searched for your evidence (briefly, YOUR search strategy, not that of the research). Include databases and keywords and reason(s) for your choice of article. 4. Synopsis: In the body of the POEM, briefly summarise the background i.e., provide a brief introduction to the problem / background to the question (you may use other references to support this); describe the population studied; describe and analyse the study design and validity; outline the outcomes measured; describe and critically analyse main results. (Point 4 should form the main part of your POEM.) 5. Levels of evidence: Indicate the levels of evidence provided by this research (see Table A NHMRC evidence hierarchy). 6. Bottom line: Make recommendations for clinical practice, based on the research outcomes of the source article chosen.

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APPENDIX R – RCA Summative Assessment Task

All of the above six points must be included. Do not introduce new information into the “bottom-line”, it is intended to be a brief “answer” to your clinical question (if indeed it can be answered by this research) based on the research outcomes. Your POEM should be correctly referenced.

Published medical literature exist that uses this format of presentation already; for instance, DARE (Database of Abstracts of Reviews of Effects) reviews POEMs published in medical journals. Students are NOT permitted to use one of these as their source article, but are required to interpret the outcomes of the research themselves and translate these into relevant recommendations. While reference to the source is required, avoid direct quotation of the research results. Using and Presenting Evidence The type of evidence required will vary with the clinical question. How to Review the Evidence: Systematic Identification and Review of the Scientific Literature (NHMRC 1999) lists six different types of questions.  Interventions (‘What are the effects of an intervention?’) - ideal study design is a randomised controlled trial (RCT).  Frequency or rate (‘How common is a particular condition or disease in a specified group in the population?’) - for which the ideal study design is a cross-sectional survey with a standardised measurement in a representative (e.g. random) sample of people; for a rate, the sample population would need to be followed over time.  Diagnostic test performance (‘How accurate is a sign, symptom, or diagnostic test in predicting the true diagnostic category of a patient?’) - for which the ideal study design is a representative sample of people in whom the new test is compared to an appropriate ‘gold standard’ (case-control or cross-sectional study).  Aetiology and risk factors (‘Are there known factors that increase the risk of the disease?’) - for which the ideal study design is long-term follow-up of a representative inception cohort or an approximation to this through a case-control study.  Prediction and prognosis (‘Can the risk for a patient be predicted?’) - for which the ideal study design is long-term follow-up of a representative inception cohort (cohort or survival study).  Economic analysis (‘What are the overall costs of using the procedure?’) - which is not a separate question but involves consideration of additional outcomes (resources and their costs) within one of the other questions.

Assessment task: Prepare and submit a POEM on one of the topics below Due date: Midnight, Sunday 21st August 2016 Electronic submission via eLearning Space

Topic selection: Choose ONE of the following topics (500 - 850 words)

1. Is there a role for the new drug ivacaftor in the treatment of patients with cystic fibrosis?

2. Can music therapy have a role in improving cognitive function among older people?

3. Does statin therapy play a role as an adjunct treatment for chronic hepatitis C?

4. Are decision aids helpful for patients making choices about surgery?

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APPENDIX S - RCA Assessment: NHMRC

Table A: NHMRC Evidence Hierarchy: designations of ‘levels of evidence’ according to type of research question (including explanatory notes) Level Intervention 1 Diagnostic accuracy 2 Prognosis Aetiology 3 Screening Intervention A systematic review of A systematic review of A systematic A systematic A systematic review of I 4 level II studies level review of review of level II level II studies II studies level II studies studies A randomised controlled A study of test accuracy A prospective A prospective A randomised controlled 7 trial with: an independent, cohort study cohort study trial blinded comparison with a valid reference II standard,5 among consecutive persons with a defined clinical presentation6 A pseudorandomised A study of test accuracy All or none8 All or none8 A pseudorandomised controlled trial with: an independent, controlled trial (i.e. alternate allocation blinded comparison with (i.e. alternate allocation or some other method) a valid reference or some other method) III-1 standard,5 among non- consecutive persons with a defined clinical presentation6 A comparative study A comparison with Analysis of A retrospective A comparative study with with concurrent reference standard that prognostic cohort study concurrent controls: controls: does not meet the factors ▪ Non-randomised, ▪ Non-randomised, criteria required for amongst experimental trial experimental trial9 Level II and III-1 persons in a ▪ Cohort study III-2 ▪ Cohort study evidence single arm of ▪ Case-control study ▪ Case-control study a randomised ▪ Interrupted time controlled series trial with a control group A comparative study Diagnostic case-control A A case-control A comparative study without concurrent study6 retrospective study without concurrent controls: cohort study controls: ▪ Historical control ▪ Historical control study study ▪ Two or more single ▪ Two or more single III-3 arm arm study study10 ▪ Interrupted time series without a parallel control group Case series with either Study of diagnostic yield Case series, or A cross-sectional Case series post-test or pre- (no reference standard)11 cohort study study or case test/post-test outcomes of persons at series IV different stages of disease

http://www.health.qld.gov.au/healthpact/docs/gen-docs/lvl-of-evidence.pdf

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APPENDIX S - RCA Assessment: NHMRC

Explanatory notes: 1 Definitions of these study designs are provided on pages 7-8 How to use the evidence: assessment and application of scientific evidence. 2 The dimensions of evidence apply only to studies of diagnostic accuracy. To assess the effectiveness of a diagnostic test there also needs to be a consideration of the impact of the test on patient management and health outcomes. 3 If it is possible and/or ethical to determine a causal relationship using experimental evidence, then the ‘Intervention’ hierarchy of evidence should be utilised. If it is only possible and/or ethical to determine a causal relationship using observational evidence (ie. cannot allocate groups to a potential harmful exposure, such as nuclear radiation), then the ‘Aetiology’ hierarchy of evidence should be utilised. 4 A systematic review will only be assigned a level of evidence as high as the studies it contains, excepting where those studies are of level II evidence. Systematic reviews of level II evidence provide more data than the individual studies and any meta-analyses will increase the precision of the overall results, reducing the likelihood that the results are affected by chance. Systematic reviews of lower level evidence present results of likely poor internal validity and thus are rated on the likelihood that the results have been affected by bias, rather than whether the systematic review itself is of good quality. Systematic review quality should be assessed separately. A systematic review should consist of at least two studies. In systematic reviews that include different study designs, the overall level of evidence should relate to each individual outcome/result, as different studies (and study designs) might contribute to each different outcome. 5 The validity of the reference standard should be determined in the context of the disease under review. Criteria for determining the validity of the reference standard should be pre-specified. This can include the choice of the reference standard(s) and its timing in relation to the index test. The validity of the reference standard can be determined through quality appraisal of the study. 6 Well-designed population based case-control studies (e.g. population based screening studies where test accuracy is assessed on all cases, with a random sample of controls) do capture a population with a representative spectrum of disease and thus fulfil the requirements for a valid assembly of patients. However, in some cases the population assembled is not representative of the use of the test in practice. In diagnostic case-control studies a selected sample of patients already known to have the disease are compared with a separate group of normal/healthy people known to be free of the disease. In this situation patients with borderline or mild expressions of the disease, and conditions mimicking the disease are excluded, which can lead to exaggeration of both sensitivity and specificity. This is called spectrum bias or spectrum effect because the spectrum of study participants will not be representative of patients seen in practice. 7 At study inception the cohort is either non-diseased or all at the same stage of the disease. A randomised controlled trial with persons either non-diseased or at the same stage of the disease in both arms of the trial would also meet the criterion for this level of evidence. 8 All or none of the people with the risk factor(s) experience the outcome; and the data arises from an unselected or representative case series which provides an unbiased representation of the prognostic effect. For example, no smallpox develops in the absence of the specific virus; and clear proof of the causal link has come from the disappearance of small pox after large-scale vaccination. 9 This also includes controlled before-and-after (pre-test/post-test) studies, as well as adjusted indirect comparisons (i.e., utilise A vs B and B vs C, to determine A vs C with statistical adjustment for B). 10 Comparing single arm studies i.e. case series from two studies. This would also include unadjusted indirect comparisons (i.e. utilise A vs B and B vs C, to determine A vs C but where there is no statistical adjustment for B). 11 Studies of diagnostic yield provide the yield of diagnosed patients, as determined by an index test, without confirmation of the accuracy of this diagnosis by a reference standard. These may be the only alternative when there is no reliable reference standard. Note A: Assessment of comparative harms/safety should occur according to the hierarchy presented for each of the research questions, with the proviso that this assessment occurs within the context of the topic being assessed. Some harms are rare and cannot feasibly be captured within randomised controlled trials; physical harms and psychological harms may need to be addressed by different study designs; harms from diagnostic testing include the likelihood of false positive and false negative results; harms from screening include the likelihood of false alarm and false reassurance results. Note B: When a level of evidence is attributed in the text of a document, it should also be framed according to its corresponding research question e.g., level II intervention evidence; level IV diagnostic evidence; level III-2 prognostic evidence.

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APPENDIX T - RCA POEM Marking Sheet

Student Name: Subject & Session  MEDI601  Session 1  MEDI602  Session 2  MEDI603  Session 3 Student Number: Due Date: / /  MEDI604 Markers:  For each of the seven marking categories, please circle the appropriate achievement of the student.  Please provide an overall “score” based on the ratings; although not all categories should be given equal weight

Marking Excellent Satisfactory Unsatisfactory Category Level of Comprehensive critical analysis of Some critical analysis of strengths Analysis of source is descriptive critical strengths and limitations of source and limitations of source rather than analytical analysis Supporting Student literature search strategy Student literature search strategy Student literature search strategy the question provided is complete and succinct provided is adequate is unsatisfactory or absent Excellent source article selected to Adequate source article selected to Inappropriate source article answer clinical question answer clinical question selected to answer clinical question Clinical question posed concordant Clinical question posed adequate for Clinical question posed not with assessment task assessment task relevant to assessment task Background of research question Background of research question Background of research question well outlined outlined adequately missing or inadequate Interpretation An in-depth understanding Adequate understanding An understanding of the of evidence demonstrated of the suitability of demonstrated of the suitability of the suitability of the research the research (population studied, research (population studied, (population studied, research research design and validity) to research design and validity) to design and validity) to answer answer the study question answer the study question the study question not demonstrated Excellent understanding Satisfactory understanding An understanding of the demonstrated of the outcomes demonstrated of the outcomes outcomes measured in the measured in the research measured in the research research not demonstrated Analysis Excellent description and analysis Satisfactory description and analysis Description and analysis of the of results provided of the main results of the provided of the main results of the main results of the research not research research provided or unsatisfactory Clinical An in-depth understanding An adequate understanding An understanding of the relevance demonstrated of the clinical demonstrated of the clinical research results not relevance of the research results relevance of the research results demonstrated An in-depth understanding An adequate understanding An understanding of the demonstrated of the implications demonstrated of the implications for implications for clinical practice for clinical practice clinical practice not demonstrated "Bottom-line" entirely relevant to “Bottom-line” partially relevant to “Bottom-line” irrelevant/not the clinical question posed the clinical question posed applicable to the clinical question posed “Bottom-line” represents a “Bottom-line” represents a partial “Bottom-line” is an statement of recommendation for statement of recommendation for unsatisfactory statement of clinical practice based on the clinical practice based on the recommendation for clinical research outcomes research outcomes practice based on the research outcomes and/or introduces new material

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APPENDIX T: RCA POEM Marking Sheet

Marking Excellent Satisfactory Unsatisfactory Category Written Excellent logical and coherent Satisfactory logical and coherent Lacks a logical and coherent communicatio structure structure structure n skills Appropriate scientific/professional Appropriate professional/scientific Inappropriate language and expression and style consistently expression and style mostly used style used - not used professional/scientific.

No grammatical, spelling and/or Few or minor grammatical, Major grammatical, spelling formatting errors spelling and/or formatting errors and/or formatting errors

Consistent use of preferred Few or minor inconsistencies in Preferred referencing not used referencing system preferred referencing system Word count observed Word count not observed (500- 800 words) 7. Quality of Higher order thinking demonstrated Effort and some creativity Minimal effort demonstrated intellectual to achieve an in-depth understanding demonstrated in the analysis with little intellectual endeavour through organising, synthesising and process OR the efforts are investment integrating information in new ways. acceptable but the outcome is mundane

Overall Grade

 Excellent  Satisfactory  Unsatisfactory

Comments:

1st Marker Code:_____ Date: / / 2nd Marker Code: _____ Date: / /

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APPENDIX U - RCA Critical Analysis of a Drug Advertisement

BACKGROUND Evidence gathered over many years has demonstrated that doctors’ prescribing habits are influenced by pharmaceutical company advertising, often unwittingly. Advertising is identified by some doctors as their primary source of information about current drugs. It was demonstrated at one USA medical school that this influence may already be established among medical students from their early exposure to pharmaceutical sales representatives, prior to graduation (Monaghan et al. 2003). In Australia, the advertising of therapeutic goods to consumers is regulated through the Therapeutic Goods Advertising Code 2007 and its stated objective is to ensure that the marketing and advertising of therapeutic goods to consumers is conducted in a manner that promotes the quality use of therapeutic goods, is socially responsible and does not mislead or deceive the consumer. The advertising of therapeutic goods directed exclusively to doctors and other healthcare professionals however, is governed by industry codes of practice and is not subject to this official government-regulated Code. According to the Medicines Australia Code of Conduct, promotional material provided for health professionals must be “current, accurate, balanced, and must not mislead either directly, by implication or omission” (Medicines Australia 2006). While the obvious motive of advertising is to persuade doctors to prescribe their drugs, there is also a stated aim of education. However, there is published evidence of:  bias towards prescribing of drugs according to advertising dollars spent rather than for the best outcomes for the patient;  heavy promotion at least partly responsible for the more frequent prescribing of newer (often more expensive) drugs;  inaccuracies or omissions often occurring within the advertisements;  bias towards publication of industry-funded randomised trials (Bhandari et al. 2004). Results of studies have led to conclusions that doctors may not be aware of the extent to which their prescribing is influenced by advertising. Claims made in Advertising A 2002 study of advertising claims in the Australian medical literature classified claims made as having unambiguous clinical outcomes; vague clinical outcomes; emotive or immeasurable outcomes or non-clinical outcome (e.g., drug plasma half-lives or biochemical markers). Of these claims:  less than 60% were backed by quantitative data,  less than 30% of claims could be regarded as unambiguous, and  many could not be verified against readily searched databases (e.g., Medline) (Loke, Koh & Ward 2002). The Loke, Koh & Ward study also referred to a 1986 Australian report that found that 31% of pharmaceutical advertisements were “misleading” or “unjustifiable” and another 22% were in “technical breach” of the Code as current at the time. In a recent study into the accuracy of advertising for psychiatric medication it was observed that 50% of advertisements failed to supply a readily verifiable source for their claim and up to 35% of the citations did not support the specified claim (Spielmans et al. 2008). Another study into Australian advertising of antihypertensive therapies identified a high frequency of advertising less cost- effective treatments, especially failing to indicate the trialling of lifestyle changes first (as suggested by hypertension guidelines) (Montgomery et al. 2008). That study also found that 41% of advertisements promoted their drug for a particular subgroup of patients which, if based on data from high-risk patients, could raise expectations of efficacy in other groups. Two thirds of advertisements claimed reduced risk, danger or harm rather than a clear clinical outcome and few reported the expected side effects except perhaps in the fine print (Montgomery et al. 2008).

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APPENDIX U - RCA Critical Analysis of a Drug Advertisement

AIMS The aims of this assessment task are to:  recognise the implicit and explicit claims made in the advertisement,  develop the student’s literature research skills as the claims in the advertisement are researched,  increase the student’s awareness of the advertised drug or drug class, its actions and side effects and where it fits in the treatment options for the condition for which it is approved,  discuss the quality of the evidence supporting the claims made in the advertisement,  increase the student’s awareness of ethics in advertising, paying particular attention to the explicit guidelines of the World Health Organisation identified below, and  make valid conclusions as to the therapeutic role of the advertised product. Assignment You are to choose ONE of the advertisements out of the options provided and write a critical review of it. Each has different substantiations of the therapeutic claims made. You are required to construct an analysis based on the questions below concerning the advertisement that you have chosen. Your report should be written keeping in mind the World Health Organisation (WHO): Ethical Criteria for Medicinal Drug Promotion 1988. This includes specifically:  All promotion-making claims concerning medicinal drugs should be reliable, accurate, truthful, informative, balanced, up-to-date, capable of substantiation and in good taste. They should not contain misleading or unverifiable statements or omissions likely to induce medically unjustifiable drug use or give rise to undue risks.  Comparison of products should be factual, fair and capable of substantiation.  Advertisements may claim that a drug can cure, prevent or relieve an ailment only if this can be substantiated.  Language which brings fear or distress should not be used. You are also recommended to refer first to the website of “Healthy Skepticism” www.healthyskepticism.org , in particular AdWatch, which illuminates the techniques used in drug advertisements. http://www.healthyskepticism.org/adwatch.php It is worthwhile reading discussions on drug advertisements found on this site: for instance, search for ‘Amylin’ to locate the article, “Amylin and Ely Lilly’s Byetta ® (exanatide injection) for type 2 diabetes from October 2009. The discussion here observes some of the techniques used for you to look out for, which may help you in the critical analysis of the advertisement you have chosen.

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APPENDIX U - Critical Analysis of a Drug Advertisement

Provide a brief review of the actions, indications and side effects of the medication being advertised with reference to published data. Consider:  What is the mechanism by which the drug exerts its therapeutic effect?  What other drugs can be used to treat the same condition?  How does this drug fit with other treatment options? Analysis of the claims made for the drug and the nature of the support for the claims.  What claims are made in the advertisement? (visual, implied, actual)  Select two therapeutic claims being made about the drug in the advertisement. o Are these claims justified by the cited references? o Do the findings reported in the references quoted justify the claims in the advertisement? (You are only required to review two references.)  How does the pharmaceutical company claim that their drug is distinct from other drugs used to treat the same condition?  Are these claims justified?  Discuss the quality of the papers selected. Are there other articles available that may express a different view that have not been quoted? The advertisements themselves and references unavailable through the library or internet will be provided via your e- readings link on the Phase 2 eLearning site. Formative (maximum 850 words): ___ _ Due: Midnight, Sunday, 23rd October, 2016 The advertisement for review for your formative assignment deals with oxybutynin (Oxytrol). The resources needed to complete the formative assessment are located on your elearning site. They consist of a recording of a lecture presented by Margaret Jordan (National Prescribing Service Pharmacist Facilitator) plus the accompanying PowerPoint slides. No live lecture will be presented for this assessment task. Summative (maximum 850 words): _ ___ Due: Midnight, Sunday, 20th November 2016 You have a choice of three advertisements for your summative assignment. 1. tiotropium & olodaterol (Spiolto™) 2. pregabalin (Lyrica™) 3. exenatide (Byetta™) References: Bhandari, M., Busse, J. W., Jackowski, D., Montori, V. M., Schunemann, H., Sprague, S., Mears, D., Schemitsch, E. H., Heels-Ansdell, D. & Devereaux, P. J. 2004, 'Association between industry funding and statistically significant pro- industry findings in medical and surgical randomized trials', CMAJ, vol.170, no.4, pp.477-480. Loke, T. W., Koh, F. C. & Ward, J. E. 2002, 'Pharmaceutical advertisement claims in Australian medical publications', Medical Journal of Australia, vol.177, pp.29-293. Medicines Australia 2006, Retrieved, 17th July, 2009, http://www.medicinesaustralia.com.au/pages/images/Medicines_Australia_Code_of_Conduct_Edition_15.pdf. Monaghan, M. S., Galt, K. A., Turner, P. D., Houghton, B. L., Rich, E. C., Markert, R. J. & Bergman-Evans, B. 2003, 'Student understanding of the relationship between the health professions and the pharmaceutical industry', Teaching and Learning in Medicine, vol.15, no1, pp.14-20. Montgomery, B. D., Mansfield, P. R., Spurling, G. K. & Ward, A. M. 2008, 'Do advertisements for antihypertensive drugs in Australia promote quality prescribing? A cross-sectional study', BMC Public Health, vol.8, p.167. Spielmans, G. I., Thielges, S. A., Dent, A. L. & Greenberg, R. P. 2008, 'The accuracy of psychiatric medication advertisements in medical journals', Journal of Nervous and Mental Disease, vol.196, no.4, pp.267-273.

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APPENDIX V - RCA Critical Analysis of a Drug Advertisement Marking Sheet

Student Name: Subject & Session  MEDI601  Session 1  MEDI602  Session 2  MEDI603  Session 3 Student Number: Due Date: / /  MEDI604

Markers:  For each of the seven marking categories, please circle the appropriate achievement of student.  Please provide an overall “score” based on the ratings; although not all categories should be given equal weight.  For some of the marking criteria there are not three grades to choose from.

Marking Category Excellent Satisfactory Unsatisfactory

1. Review of An accurate and succinct An adequate summary of the An incomplete summary of the medication summary of the actions, actions, indications, side effects actions, indications, side effects indications, side effects and and role of advertised medication and role of advertised role of advertised medication provided, using standard medication given; or provided, using standard therapeutics texts. inappropriate texts or references therapeutics texts. used.

2. Recognition of All therapeutic claims - Most therapeutic claims - Therapeutic claims not correctly therapeutic claims implied or explicit - implied or explicit - identified identified. made in identified and explained. and explained. advertisement 3. Analysis of Support for therapeutic Support for therapeutic claims Analysis of justification for therapeutic claims well described and adequately described and therapeutic claim/s missing or claim/s analysed; includes analysed; includes identification inadequate. identification of lack of of lack of justification of claims justification of claims where where relevant. relevant.

4. Relevance An in-depth understanding Some understanding of the An understanding of the clinical demonstrated of the clinical clinical relevance of the relevance of the therapeutic relevance of the therapeutic therapeutic claims demonstrated. claims not demonstrated. claims.

5. Review of Excellent review of Adequate review of references Review of references inadequate evidence/ references supporting claims supporting claims in and/or additional literature not literature in advertisement, as well as advertisement, as well as reviewed. analysis of additional cited acceptable analysis of additional literature. cited literature.

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APPENDIX V - RCA Critical Analysis of a Drug Advertisement Marking Sheet

Marking Excellent Satisfactory Unsatisfactory Category 6. Written Excellent logical and coherent Satisfactory logical and Lacks a logical and coherent communication structure. coherent structure. structure. skills Appropriate professional / Appropriate professional / Inappropriate language and style scientific expression and style scientific expression and used - not professional/ consistently used. style mostly used. scientific. No grammatical, spelling Few or minor grammatical Major grammatical and spelling and/or formatting errors. and spelling errors. errors. Consistent use of preferred Few or minor inconsistencies Preferred referencing system not referencing system. in preferred referencing used. system. Word count observed (850 Word count not observed. words).

7. Quality of Higher order thinking Effort and some creativity Minimal effort demonstrated intellectual demonstrated; e.g., excellent demonstrated in the analysis without intellectual investment. endeavour consideration given to the process OR the efforts are ethics of drug promotion. acceptable but the outcome is mundane.

Overall Grade  Excellent  Satisfactory  Unsatisfactory

Comments:

1st Marker Code:_____ Date: / / 2nd Marker Code: _____ Date: / /

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APPENDIX W – National Prescribing Curriculum (NPC) online Modules

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APPENDIX X – Addressing learner disorientation: Give them a roadmap

Level 1 2 3 4

knows how (general) History- novice knows how (speciality specific) thorough Detective taking knows the content and process of a consistently clarifies important history consistently “clerking history” details(purpose of duration of geared to narrowing the treatments, details of symptoms differential diagnosis “bile or no bile: etc) (relevant positives and negatives) knows how (general)

Examining novice knows how (speciality specific) thorough detective

knows the content and process of a consistently clarifies important examination “clerking history” details (is tachypnoea consistently geared to obstructive or not, is murmur narrowing differential systolic or diastolic) diagnosis (goes looking

Domain for the relevant findings) Interpreting novice knows about conditions forms an opinion seeks evidence for and against opinion knows the important causes of the consistently offers a defensible formulating view affects presenting complaint view about the most likely the order and emphasis cause(s) of history and examination

Managing novice knows about tests and treatments suggests a plan individualises plan knows tests and treatments for the consistently offers a defensible data gathered during important causes of the presenting investigation and treatment the history and complaint plan examination used to gear the plan to the individual patient

Relating to novice polite and professional listens and explains patient-centred patients consistently enables questions consistently gears and takes them seriously; questioning, provides explanations explanations and plans to individual patients (puts him/herself in the patient’s shoes)

An example roadmap. The figure illustrates a framework or map setting out four developmental stages for each of five elements and describing what it looks like to progress from a first-day student or novice to a skilful doctor. This represents the “big picture” view within which any learning activity can be located and, thereby, given meaning. For example, most of the conventional pre-clinical sciences help the student to make the transition from Interpretation and Managing level 1 to level 2. Clinical skills courses (as distinct from procedural skills courses) help the student to make the transition from history- taking and examining level 1 to level 2—or perhaps 3. Courses on communication skills and professionalism help students to move from Relating to Patients level 1 or 2 to 2 or 3. Most of the higher transitions require supervised clinical encounters with feedback. This particular map does not integrate the procedural skills, but, clearly it would entirely possible to do so within the managing dimension.

Medical Teacher, Addressing learner disorientation: Give them a roadmap by Crossley, James G.M ISSN 0142-159X, 08/2014, Volume 36, Issue 8, pp. 685 - 691

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