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MEDIC ST 5016AHO - Human Reproductive Health Part 1

Teaching Hospitals - Semester 1 - 2019

The clinical attachments are a program of clinical education through a selection of placements so that students will be competent in history-taking, patient examination and management. This includes problem formulation, investigations, treatment (pharmacological and non-pharmacological), counselling, good communication skills, the practice of empathetic medicine, and a sound knowledge base that allows diagnosis and management of common disorders to be carried out under appropriate supervision.

  • General Course Information
    Course Details
    Course Code MEDIC ST 5016AHO
    Course Human Reproductive Health Part 1
    Coordinating Unit Medical Studies
    Term Semester 1
    Level Undergraduate
    Location/s Teaching Hospitals
    Contact Attachments, common program & research
    Available for Study Abroad and Exchange N
    Prerequisites MEDIC ST 4000AHO/BHO, MEDIC ST 4013AHO/BHO, MEDIC ST 4014 AHO/BHO, MEDIC ST 4015 AHO/BHO, MEDIC ST 4016 AHO/BHO, MEDIC ST 4017 AHO/BHO, MEDIC ST 4018 AHO/BHO, or by approval of the Dean of Medicine
    Restrictions Available to MBBS students only
    Assessment Details provided at start of year
    Course Staff

    Course Coordinator: Associate Professor Paul Duggan

    Course Coordinator
    Name Phone Email Location
    Associate Professor Paul Duggan +61 8 8313 7619 paul.duggan@adelaide.edu.au Women’s and Children’s Hospital

    Additional Acacdemic Staff

    Name Phone Email Location
    Professor Jodie Dodd +61 8 81617619 Jodie.dodd@adelaide.edu.au Women’s & Children’s Hospital
    Professor Gus Dekker   +61 8 81829306 Gustaaf.dekker@adelaide.edu.au Lyell McEwin Hospital

    Administration

    Name Email Location
    WCH & CALHN Precinct Support Officers wch@adelaide.edu.au Women’s & Children’s Hospital
    LMH Precinct Support Officers lmh@adelaide.edu.au Lyell McEwin Hospital






    Course Timetable

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

    The course timetable for the  rotation is made available to students on the first day of the placement.
  • Learning Outcomes
    Course Learning Outcomes
    OUTCOMES (Curriculum Mapping)

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

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

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

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

    This course will provide students with an opportunity to develop the Graduate Attribute(s) specified below:

    University Graduate Attribute Course Learning Outcome(s)
    Deep discipline knowledge
    • informed and infused by cutting edge research, scaffolded throughout their program of studies
    • acquired from personal interaction with research active educators, from year 1
    • accredited or validated against national or international standards (for relevant programs)
    1-3
    Critical thinking and problem solving
    • steeped in research methods and rigor
    • based on empirical evidence and the scientific approach to knowledge development
    • demonstrated through appropriate and relevant assessment
    1-3
    Teamwork and communication skills
    • developed from, with, and via the SGDE
    • honed through assessment and practice throughout the program of studies
    • encouraged and valued in all aspects of learning
    1-3
    Career and leadership readiness
    • technology savvy
    • professional and, where relevant, fully accredited
    • forward thinking and well informed
    • tested and validated by work based experiences
    1-2
    Intercultural and ethical competency
    • adept at operating in other cultures
    • comfortable with different nationalities and social contexts
    • able to determine and contribute to desirable social outcomes
    • demonstrated by study abroad or with an understanding of indigenous knowledges
    1-3
    Self-awareness and emotional intelligence
    • a capacity for self-reflection and a willingness to engage in self-appraisal
    • open to objective and constructive feedback from supervisors and peers
    • able to negotiate difficult social situations, defuse conflict and engage positively in purposeful debate
    2-3
  • Learning Resources
    Required Resources
    There are no required resources. Recommended resources will be advised as appropriate.
    Recommended Resources
    General Texts suitable for student purchase

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

    Essential Obstetrics & Gynaecology. Ian M Symonds and S Arulkumaran. (5th edition) 2013 Churchill Livingstone. NB! new edition expected 2019


    Electronic Based Reference

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

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

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

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

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

    Motherisk: www.motherisk.org

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

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

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

    Sexual health www.mshc.org.au
    Online Learning
    On line Lectures: refer to Canvas course, plus

    eMedicihttp://emedici.com
  • Learning & Teaching Activities
    Learning & Teaching Modes
    We emphasise active learning methods including: case based learning, large group lectures, seminars, tutorials and clinics and other sessions in our teaching hospitals. Self-directed research and/or study, case presentations, and critical analysis are encouraged.


    Clinical Learning

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

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

    Labour Ward
    Students are usually rostered to the labour ward four times during their rotation. These are all day sessions and include weekend and after-hours work. They aim to provide students with the opportunity to observe the process of labour and delivery, to participate in the routine intrapartum observations of the mother and fetus, and to conduct spontaneous vaginal deliveries including management of the third stage with the help of the midwifery staff in charge.

    Gynaecological duties
    Students are rostered to attend gynaecological outpatient sessions where there will be the opportunity to take a history and examine outpatients with the Consultant/Registrar attending the Clinic. Students should attend operating theatre sessions and participate in the immediate preoperative round before attendance in the operating room. Students should ensure a familiarity with the commonly performed gynaecological procedures. The postoperative progress of the patient(s) who have been clerked should be followed and the pathology reports should be examined before discharge

    Neonatal Medicine
    Students will have regular neonatal tutorials and will also be rostered to follow neonatology staff for a session.  Students should be able to demonstrate skills in the examination of the normal neonate and knowledge of common problems that occur in the neonatal period.

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


    e-Learning
    Students are encouraged to access the eLearning modules made available in My Uni utilising their own devices. iPads provided by the Discipline must be used to undertake on-line written assessments. eMedici now includes case material and related formative assessment in Obstetrics and Gynaecology.


    Workload

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

    Workload for the individual students will vary from week to week but students can assume that on average they will work a 45 hour week which will include clinic sessions, lectures (both delivered and online), seminars, tutorials and private study. After hours and weekend work may also be required to meet clinical requirements.
    Learning Activities Summary
    The thematic structure of the Year 5 MBBS Program will be provided and discussed at the start of the program and is discussed in detail in the student handbook (provided to students on the first day of their rotation). Please note that the following applies only to the metropolitan students undertaking Human Reproductive Health. Students attached to the Discipline of Rural Health undergo separate orientation and clinical learning opportunities.

    Week Topic Lecture
    Week 1 Warm up week Introduction to the course including whole-of-class tutorials covering the basicsand including small group clinical skillssessions.
    Weeks  2 - 9 Students are allocated to specific hospital-based attachments and have individual learning timetables for the clinical component of the course. On line lectures are available in MyUni and eMedici, including access to on line formative assessments.A separate lecture timetable for Friday afternoon tutorials held in the RobinsonInstitute seminar room will be announced. A mid-term summative MCQ with immediate post test feeedback will be availale.
    Week 9 Summative assessment week Assessment of knowledge, reasoning and clinical skills will be undertaken in week 9.
    Specific Course Requirements
    All students will be allocated to Lyell McEwin Hospital or the Women’s and Children’s Hospital in the metropolitan area.   Although allocated to one hospital all students should expect to travel to other hospitals (Modbury, The Queen Elizabeth Hospital, Royal Adelaide Hospital) and places for specialty sessions.  

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

    All students will be required to do some after-hours and weekend work (see above). Any other requirements will be advised.
    Small Group Discovery Experience
    A mandatory small group contraception tutorial under expert tuition is held mid-term. A "flipped classroom" approach is used. Advanced preparation by accessing the Contraception module in My Uni is required.
  • Assessment

    The University's policy on Assessment for Coursework Programs is based on the following four principles:

    1. Assessment must encourage and reinforce learning.
    2. Assessment must enable robust and fair judgements about student performance.
    3. Assessment practices must be fair and equitable to students and give them the opportunity to demonstrate what they have learned.
    4. Assessment must maintain academic standards.

    Assessment Summary

    Assessment Task Assessment Type Weighting Learning outcome(s) being addressed
    Single best answer written examination end of week 5 Summative and formative 15% 1 and 2
    Clinical portfolio end of week 8 Summative 30% 1
    Single best answer written examination week 9 Summative 25% 1
    OSCE examination week 9 Summative 30% 2
    Assessment Detail
    Clinical Portfolio
    There are three components to the Clinical Portfolio all requiring on-line submission via My Uni.

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

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

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

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

    Grades for your performance in this course will be awarded in accordance with the following scheme:

    NOG (No Grade Associated)
    Grade Description
    CN Continuing

    Further details of the grades/results can be obtained from Examinations.

    Grade Descriptors are available which provide a general guide to the standard of work that is expected at each grade level. More information at Assessment for Coursework Programs.

    Final results for this course will be made available through .

    If a replacement or additional assessment is required, this will normally take the form of a clinical viva assessment, which may include an observed long case and oral assessment covering both the long case and a range of other topics.
  • Student Feedback

    The University places a high priority on approaches to learning and teaching that enhance the student experience. Feedback is sought from students in a variety of ways including on-going engagement with staff, the use of online discussion boards and the use of Student Experience of Learning and Teaching (SELT) surveys as well as GOS surveys and Program reviews.

    SELTs are an important source of information to inform individual teaching practice, decisions about teaching duties, and course and program curriculum design. They enable the University to assess how effectively its learning environments and teaching practices facilitate student engagement and learning outcomes. Under the current SELT Policy (http://www.adelaide.edu.au/policies/101/) course SELTs are mandated and must be conducted at the conclusion of each term/semester/trimester for every course offering. Feedback on issues raised through course SELT surveys is made available to enrolled students through various resources (e.g. MyUni). In addition aggregated course SELT data is available.

    A student course evaluation is completed online by all students at the end of the rotation.  SELTS of individual teaching are done on a regular basis.
  • Student Support
  • Policies & Guidelines
  • Fraud Awareness

    Students are reminded that in order to maintain the academic integrity of all programs and courses, the university has a zero-tolerance approach to students offering money or significant value goods or services to any staff member who is involved in their teaching or assessment. Students offering lecturers or tutors or professional staff anything more than a small token of appreciation is totally unacceptable, in any circumstances. Staff members are obliged to report all such incidents to their supervisor/manager, who will refer them for action under the university's student鈥檚 disciplinary procedures.

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