成人大片

Academic

A/Prof Mellick Chehade
Course Coordinator
Location:
Royal Adelaide Hospital
Bice Building, Level 4, Room 31
Email: Mellick.Chehade@adelaide.edu.au

A/Prof Susanna Proudman
Associate Course Coordinator / Senior Rheumatologist  
Location:
Royal Adelaide Hospital
Rheumatology Unit Level 4, Eleanor Harrald Bldg
Email: susanna.proudman@health.sa.gov.au
Telephone: 08 8222 5190

A/Prof Vidya Limaye – Rheumatology
Location: Rheumatology Unit
Royal Adelaide Hospital
Level 4, Eleanor Harrald Bldg
Email: Vidya.limaye@health.sa.gov.au
Telephone: 08 8222 5190

Dr Sam Whittle – Rheumatology
Location:
The Queen Elizabeth Hospital
Rheumatology Unit, 5C
Email: sam@whit.tl
Telephone: 08 8222 6688

Dr. Ruth Marshall – Rehabilitation
Location:
Hampstead Rehabilitation Centre
Orthopaedic, Amputee & Spinal Injury Rehabilitation Service
Email: Ruth.Marshall@health.sa.gov.au
Telephone: 08 8222 1630

Further details on the timetable will be made available on the placement

With respect to musculoskeletal practice the graduating medical student will:

1. Exhibit professionalism and effective communication skills towards patients and their families, colleagues, co-workers and the general community.

2. Perform an adequate assessment of the range of common and serious MSK related presentations to distinguish normal from abnormal and develop a limited and reasonable differential diagnosis. This includes the ability to apply knowledge and understanding of normality and the characteristic distinguishing features of MSK conditions in order to take a focussed history, perform a targeted physical examination, select appropriate further investigations and use critical reasoning in the interpretation of findings and formulation of diagnoses.

3. Develop a holistic, patient focussed and evidence informed management plan based on knowledge and understanding of the key principles of management of the broad spectrum of MSK conditions and the range of related issues that may influence individual management decisions. This includes therapeutic (operative and non- operative); rehabilitation; patient education and self-management; shared care and referral; prevention; and complementary and alternative medicine strategies.

4. Diagnose and initiate treatment and referral in the management of emergency MSK conditions. This includes the correct and safe performance of basic procedures such as joint injection, limb realignment and splintage.

Apley A E, & Solomon L., 1988, Concise system of Orthopaedics and Fractures, Butterworth & Co Ltd 1988. (ISBN 0-407-00325-8)

1. Eizenberg, N, Briggs, C, Adams, C and Ahern, G, General Anatomy Principles and Applications, McGraw Hill Medical, Australia
2. Slater, R B, 1999, Textbook of Disorders and Injuries of the Musculoskeletal System, 3rd Edition, (ISBN 0-683-07499-7)
3. Therapeutic Guidelines: Rheumatology, version 2, 2010, URL Available:
4. Sambrook P, Schrieber L, Taylor T.K. F , Ellis A, 2010 , The Musculoskeletal System (Systems of the Body), Churchill Livingstone – ISBN 0-443-07015-6.
5. Kanoso, J.J, 1997, Rheumatology in Primary Care (W B Saunders and Co)
6. Penington G.R , Burry H. C, 1990, Introduction to Medical Rehabilitation - An Australasian Perspective, Melbourne University Press, ISBN: 0-522-84391-3
7. Grundy D, and Swain A, 1996, ABC of Spinal Cord Injury, 3rd Edition, BMJ Publishing Groups

Medical Journal of Australia, Practice Essentials in Rheumatology 96/97
· Vol 165, Nos 6-10
· Vol 166, Nos 1-8
Harrisons (appropriate chapters 308-331)

See Course Handbook for more details.

MyUni
Orthopaedics
Each learning resource follows a specific format consisting of:
• Module objectives: Each module will be prefixed with the relevant objectives that students should aim to achieve by completing the module.
• Modules are located within the Topics Section of MyUni

Rheumatology
The on-line lectures and videos provided are essential pre-requisites before commencing any part of the Rheumatology component of the Musculoskeletal Medicine course. The lectures "Assessing the patient with joint pain" and "Immunology for Rheumatology" and the video on the musculoskeletal examination are especially important for developing your knowledge base in Rheumatology.
On-line discussions
Online Discussion Boards will be used to facilitate asynchronous learning. Students may be asked to post any questions on any given topic. Each question should start a new thread. Please do not post questions that have already been submitted. However, please feel free to answer and contribute to any questions posted by other students that you would like to attempt. The questions posted will be reviewed via the discussion board and feedback will be provided online by a tutor shortly after.

Other
It is highly recommended that students register and access the Rheumatology Website, www.jointzone.org*. Go to ‘Approach to Patient’, to access the Musculoskeletal examination and watch the video for the Quick Screening Examination (GALS).
• www.rheumatology.org.au* (Australia Rheumatology association website). Go to Patient: patient information sheets for information about drugs used in rheumatology and information sheets for patients.Osteoporosis Australia
• Arthritis UK:
• Radiopolis
• Other websites as directed by the e-learning modules.

Online
See Online Learning above

Anatomy teaching
Anatomy sessions will be held at the Ray Last Laboratory in the Medical School Basement. Please note: students must wear white coats during these sessions in week one.

Tutorials
Representative cases are used to direct your learning about the more common types of arthritis Clinical Tutorials will be scheduled on a weekly basis throughout the rotation. Students are expected to attend each tutorial offered, unless prevented from doing so by illness and or extenuating circumstances. At the RAH, all tutorials will be located in the Orthopaedics and Trauma Department Lecture Room unless otherwise advised.

It is critical that students review the relevant tutorial content prior to attending tutorials. The success and strength of this program is dependent on the pre-tutorial preparation which is directed on-line. Student participation and interaction with the content on MyUni is monitored and staff are able to view a very detailed report of which sections have been accessed on an individual student basis.

Clinical teaching

Outpatient clinics
Oupatient sessions in rheumatology and orthopaedics are scheduled at the Royal Adelaide, Modbury Hospital and The Queen Elizabeth Hospitals. All outpatient clinics are themed and you may be scheduled to attend one or more of the different themed clinics. It is expected that students attend all of their allocated OPD sessions, and non-attendance will require justification.

Operating theatre 
All students should get the opportunity to see the operations listed below. The trauma cases can usually be seen on one of the orthopaedic “takes” or alternatively on the “mop up” trauma lists on the day following the “take”.  Theatre sessions are rostered by Sarah Downey and placed on MyUni.  

Students must ensure that they adhere to the Guidelines for Medical Students in RAH Operating Theatres.

Recommended Surgical Procedures to Have Been Observed

Elective	Emergency
Total Knee Arthroplasty	Wrist fracture – closed reduction
Total Hip Arthroplasty	Intramedullary nailing of fractured tibia or femur
	Open reduction and internal fixation of ankle +/- forearm fracture
	Fixation of fractured NOF

One-on-one case-taking (rheumatology)
This is an opportunity for you to spend time taking a detailed history and examination focussed on all systems, drawing on your clinical skills training from previous years. This case needs to be written up and submitted via MyUni by the end of week 6.  

RAH Orthopaedic “takes”
During the six-week rotation students are expected to attend at least one weekend take and two weekday takes- students should arrange a roster amongst themselves to ensure no more than two students per take.

Ward Rounds
Ward rounds begin at 7.30 am every morning. Each student is expected to have two patients at all times (the intern will assist in finding suitable patients), and to follow their progress through their hospital stay. Students can take the patients history, examine them daily as appropriate, and document their findings in the patient’s notes. It is at the morning ward round that the student should present their patients to the registrars, informing them of pertinent (succinct) information on the patient’s progress.

Trauma / X-ray Meeting
Each morning, following the ward round, there is an x-ray/trauma meeting. These start at 08:30 except on Wednesday mornings when there is an 8:15 start.  The Trauma meetings on Thursday morning’s are optional.

Consultant Rounds
Consultant patient rounds at the RAH are conducted following the Grand Round presentations on Wednesdays at 10.30am for unit 051. For 052 it is a "computer round" that follows the presentations.The only exception being if they are rostered to Early Arthritis Outpatients (students only have one opportunity to attend this clinic, therefore should miss Grand Round and Consultant Round, in order to be at the clinic by 9.30am).

Rehabilitation visit – Hampstead Rehabilitation Centre
Activities relating to Rehabilitation are organised primarily at the QEH (in second week of each groups 2 week rotation) and Hampstead centre (weeks 3 and 4 or course).  There is an online tutorial and test
At the QEH there is are focus sessions on:
- Amputation Rehabilitation
- Gait disorders
At Hampstead there is exposure to:
- Cases with amputations
- post elective surgery (e.g. hip and knee replacements)
- Post trauma surgery (e.g. fractured NOF)
- Spinal Cord Injuries (SCI) (major focus)

Workload for the individual students will vary from week to week but students can assume that on average they will work a 45 hour week which will include clinic sessions, lectures (both delivered and online), seminars, tutorials and private study but does not include after hours call.

See Learning and Teaching Modes

More detailed information about learning activities and the course schedule is available via MyUni and the course handbook.

It is an MBBS entry requirement to obtain a police check as set out in letters of offer to prospective students. Other requirements will be advised at the start of the course.

When participating in Theatre sessions, students must ensure that they adhere to the Guidelines for Medical Students in RAH Operating Theatres. Please see “Guidelines for Medical Students in RAH Operating Theatres” document available via MyUni.

Assessment Task	Task Type	Weighting	Course Learning Outcomes being assessed/achieved
Online Quizzes	Summative	15%	3, 4
Clinical Log	Summative	10%	1, 2, 3, 4
Key Clinical Examinations & Workshops Logbook (Hurdle)	Summative	20%	1, 2, 3, 4
Rheumatology Topic Short Report	Summative	10%	1, 2, 3, 4
Rehabilitation Case Presentation	Summative	10%	1, 2, 3, 4
Sports Medicine Case Presentation	Summative	10%	1, 2, 3, 4
End of Course Examination	Summative	25%	1, 2, 3, 4

To pass this course and the Fourth Year MBBS Examination Annual Examination Part 2 course, students must obtain:

•    a satisfactory result in each of the components of the summative assessment in semesters 1 and 2; and
•    a satisfactory performance in the examinations overall

If an overall borderline grade is achieved in the examinations, a student may be offered an opportunity to sit a Replacement/Additional Assessment examination.

It is compulsory for students to attend clinical placements and their specific activities in line with the principles and guidelines outlined in the Medical Student Clinical Hours document.

Exemptions to mandatory clinical placement attendance requirements may be granted by the Program Coordinator in consultation with the relevant course coordinator and year level advisor if there are exceptional medical, compassionate or extenuating circumstances as defined by the Modified Arrangements for Coursework Assessment Policy.

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

Assessment Task	Task Type	Weighting	Course Learning Outcomes Being Assessed
Online Quizzes	Summative	15%	3,4
Clinical Log Summative	Summative	10%	1,2,3,4
Key Clinical Examinations & Workshops Logbook (Hurdle)	Summative	20%	1,2,3,4
Rheumatology Topic Short Report	Summative	10%	1,2,3,4
Rehabilitation Case Presentation	Summative	10%	1,2,3,4
Sports Medicine Case Presentation	Summative	10%	1,2,3,4
End of Course Examination	Summative	25%	1,2,3,4

See Assessment Summary

More detailed information about course assessment is available via MyUni and can be found in the course handbook.

Submission details will be outlined at the beginning of the attachment.

A Student Experience of Learning and Teaching (SELT) will be used to evaluate the course at the end of the attachment. Some online modules will have specific feedback surveys attached At any point feedback, constructive criticisms or other, can be directed to A/Prof Mellick Chehade.

Students may access the University Health Practice, 61+ 08 83135050

The MBBS Program website has details on Student Well-being resources which can be accessed.

Please read the MBBS Program Code of Conduct