成人大片

Dr Nicholas Smith
Senior Lecturer
Paediatrics and Reproductive Health
Women's and Children's Hospital

Full details are located in MyUni.

1	Demonstrate an understanding of normal growth, development, puberty, immunisation, sleep, feeding requirements with demonstrated competency in identifying normal and abnormal variations in these areas. Competency in the ability to carry out developmental assessments.
2	Demonstrate a knowledge of common general paediatric conditions such as fever, vomiting and diarrhoea, UTI’s respiratory infections, asthma, cardiac murmur, rashes, obesity, failure to thrive, abdominal pain, enuresis, seizures and development problems.
3	Demonstrate knowledge of the common chronic conditions of childhood with demonstrated ability in taking a detailed clinical history, examination, discussion of appropriate differential diagnoses, investigations and treatment for each organ system with an understanding of the different roles and responsibilities of the treating clinical team. (A detailed list of common organ system disorders will have been provided to each student).
4	Demonstrate the knowledge of the emergency care of children, common surgical conditions, resuscitation procedures, and competency in common procedures such as blood sampling, urine sample collection.
5	Demonstrate knowledge of child and adolescent mental health with the demonstrable ability to take a psychiatric history from children and their families, the ability to engage e.g. with a reluctant or angry young person and the formulation of appropriate treatment plans. The demonstrable ability to understand the responsibilities and approaches to revelations of child physical/sexual abuse and the structure of Psychiatric services in South Australia. Knowledge of attachment theory and its implications for psychological health and the principles of transference and counter transference and how this is applied in a paediatric setting.
6	Identify the role of the family and the community in providing for the needs of the child with an clear understanding of the rights of children and young people and the relevant health and welfare agencies and their roles.
7	Demonstrate an understanding of the privacy issues that apply to children, proven ability to communicate and empathise with children and their families.

Essential reading
Practical Paediatrics   (7th ed, 2012)                             
ISBN: 9780443102806

Paediatric Handbook (2004)
Women’s and Children’s Hospital
Dist: Available from the Emergency Department

Recommended reading
Paediatric Clinical Examination Made Easy (5th ed revised, 2006)  
ISBN: 9780443103957

Great Ormond Street Colour Handbook of Paediatric Medicine and Surgery (2007)
ISBN: 9781874545279    

Jones’ Clinical Paediatric Surgery (6th ed, 2008)
ISBN: 9781405162678

Illustrated Textbook of Paediatrics (4th ed, 2011)
ISBN: 9780723435655

Paediatrics and Child Heath (3rd ed, 2011)
ISBN: 9781405194747

Understanding Children and Young People's Mental Health
Claveirole, Anne  &  Martin Gaughan
ISBN: 9780470723456

Further useful reading
Apley’s Concise System of Orthopaedics and Fractures (3rd ed, 2005)
ISBN: 9780340809846

Lecture Notes on Diseases of the Ear, Nose and Throat (10th ed rev, 2007)
ISBN: 9781405145084

Nelson’s Essentials of Paediatrics (6th ed, 2010)
ISBN: 9781437706437
 
Vaughn and Ashbury’s General Ophthalmology (18th ed, 2011)
ISBN: 9780071634205

Lecture Notes – Paediatrics   (8th Ed, 2011)
ISBN: 9781405145091

Major text references
Nelson’s Textbook of Paediatrics (19th ed, 2011)
ISBN: 9781437707557

Useful websites
Online Medelian Inheritance in Man (OMIM)

American Academy of Paediatrics  

Online Lectures:    

Formative MCQ’s in relation to lecture topics are available through MyUni:

Spotting the Sick Child:    

History taking and physical examination
During the first 5 weeks of the Paediatrics and Child Health attachment, there will be small group (3 to 5 student) clinical tutorials on history taking and examination in children from 0-18 years. These tutorials are conducted by consultant clinicians at the Women’s and Children’s Hospital and Lyell McEwin Hospital. They will involve learning and practice of clinical skills in taking histories in Paediatrics, and undertaking physical examination of children at different ages. The Clinical Skills Tutorials will provide information regarding the unique features of the Paediatric History.

Differences in the Paediatric History
•    History often from third party
•    Same problem may have different presentation at different ages
•    Additional parameters:

            Pregnancy, Birth and Neonatal history

            Development status and history

            Playgroup/Kindergarten/School history

            History of growth and nutrition

            Immunisation History

•    Impact of illness on family unit
•    Relevant social history
•    Detailed family history including siblings And ensure that students have strong abilities in the following.

 

Differences in Paediatric Examination

•    Assessment of growth

•    Plotting percentiles on relevant charts
•    Assessment of development

•    Understanding of assessment techniques at different stages

            e.g. neonate, toddler, school aged child, adolescent

•    The need for observational skills in examination

•    The need for patience and opportunism

•    Ability to measure blood pressure, perform ENT and eye examination at different ages

Internships
Each student will undertake 3 internships which will each be of 3 weeks duration. These will be clinical attachments, where the student will be part of the clinical unit providing patient care.  Each of the internships will be with a different clinical unit/s. For some internships students will be attached to clinical units in pairs.  Attachments will be at the Women’s and Children’s Hospital and Lyell McEwin Health Services.  Students will be responsible to the unit Registrar and Consultant. Students will take part in all unit activities i.e. acute and elective admissions, outpatient sessions and other ambulatory care, operating theatre sessions, unit audit and teaching meetings, etc.

Learning in Child and Adolescent Mental Health
Students will add to their knowledge of child and adolescent mental health by:
•    Learning how to take a developmental and psychiatric history from children and their families
•    Being able to assess mental health symptoms in children and adolescents, and generating a relevant management plan
•    Gaining an understanding of the inter-relationship between the mental health of children and adolescents and other health problems, family problems and social circumstances
•   Developing a working knowledge of other health and welfare agencies
•    Gaining confidence in approaching clinical situations that contain an element of risk e.g. self-harm and suicidality
•    Developing an approach to interviewing young people and their families with a focus on enhancing therapeutic alliance and obtaining accurate historical information.

Structure:
•    Students will have an opportunity to practice interviewing and generating management plans for young people facing emotional challenges in a simulated clinical environment. This interactive component of the course will take place twice a week, on Tuesdays and Thursdays in iLab (Norwich Building). Structured feedback and on-the-fly review of interview footage is undertaken after each session to enhance skill development for students.
•    Seminars in child and adolescent mental health will cover common issues in developmental mental health and illness.
•    Students join clinicians for outpatient appointments in the Department of Psychological Medicine, and observe live video streams of clinical reviews with an associated tutorial. The Department of Psychological Medicine is a Consultation-Liaison psychiatry service for the WCH.

Seminars, Tutorials, Pathology Session, Plastering Sessions & ICU Sessions
Over the student’s 9 week attachment seminars, tutorials, and group learning exercises will be provided. These will be held at the Women’s and Children’s Hospital.  These sessions will involve specific aspects of Paediatric Medicine, Paediatric Surgery, Child and Adolescent Mental Health, Paediatric Emergency Care, Pathology, ICU & practical skills.  

Structured Learning
Lectures (online): 30 x 45 minute sesssions

Police Check All students are required to submit a Department for Communities and Social Inclusion (DCSI) Criminal History Check to the Clinical Studies Officer on the first day of their attachment.  This will need to be the original and not a copy.

Identification badges Women’s and Children’s Hospital identification badges will be issued to each student on the first day of their attachment.  Students will need to pay a $20 deposit to receive their ID.  The deposit will be given back to the student on return of their ID badge at the end of their attachment.  These are to be worn by students at all times within the hospital. This is a security requirement and access to hospital facilities may be refused if identification badges are not available. All badges are to be returned to the Clinical Studies Officer of the Department of Paediatrics before the commencement of the end of term examination.

Dress Students are requested to dress neatly at all times. Parents, who are often under considerable stress because of the illness of their children, have certain expectations of professionals. As many children are often frightened by white coats, staff do not wear them. Therefore, students are not expected to wear white coats.

Out of Hours Work All students will be required to do out of hours on-call work at some time during their attachment.

ASSESSMENT TASK	TASK TYPE	WEIGHTING %	COURSE LEARNING OUTCOME(S)
1. Three (3) Internship Supervisor Final Assessments	Summative	N/A (Submitted/Not Submitted)	1 - 7
2. Log Book	Compulsory Formative	N/A (Submitted/Not Submitted)	1 - 7
3. Paediatric Mental Health (attendance, participation, written reflective exercises and formulations)	Summative	20%	1 - 7
4. OSCE (Medical and Surgical)	Summative	40%	5
5. MCQ	Summative	30%	1 - 7
6. Observed Clinical Assessment	Summative	10%	1 - 3

Assessment Related Requirements

Internship Supervisor Final Assessments and Log Books need to be submitted by their due dates in order for a student to be able to sit the OSCE’s in Week 9. Students need to receive a satisfactory grade on all 3 of their Internship Supervisor Final Assessments and have all 12 signatures completed on their Log Book. Attendance at ICU, Plastering and Pathology Teaching Sessions is compulsory.

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.

Log Book The Log Book is provided on the first day of the student’s attachment. It is for documentation of the minimum number of unit and ambulatory service responsibilities during the internships. The entire front page of the log book is to be completed and signed by the appropriate supervisors, the back page is beneficial and completion of the majority of these exercises should be attempted.

Internship Supervisor - Final Assessments The ‘Summative Clinical Assessment' forms for each internship are provided on the first day of the student’s attachment.   Guides to performance (Clinical Knowledge and Clinical Skills) are also  provided. Forms should be given to the internship supervisor (Unit Consultant or Registrar) at the end of the internship, and the supervisor will complete these with the student, using the guide provided. Forms will be signed by the supervisor and the student, and will be submitted by the student to the Clinical Studies Officer by the last day of each internship.  If a student receives a Borderline/ Unsatisfactory assessment from a supervisor, they should discuss remediation with their Clinical Tutorial Group tutor/ mentor at the earliest opportunity.

Observed Clinical Assessment (OCA) This assessment is undertaken with a member of the Department of Paediatrics. Each Clinical Skills Tutorial group will be allocated to one of the members of the Department of Paediatrics for assessment. Each student will be observed performing a 10-minute clinical short case. These cases could be, for example, examination of the chest of a child with asthma, or examination of the abdomen of a child with an enlarged liver. It is expected that students will demonstrate competence in their examination technique and be able to detect important signs such as wheeze or hepatomegaly.  Assessments will encompass the domains of Clinical Examination technique, and identification and interpretation of clinical signs. Feedback regarding performance in this assessment will be provided in the final clinical skills tutorial.

OSCE (Medical & Surgical) The Medical OSCE consists of 5 stations each 5 minutes in duration testing core competencies in Paediatric Medicine.  There may be a combination of 4 active stations (with examiners) and 1 static station (written responses to questions). The Surgical OSCE consists of 3 stations each 7 minutes in duration on Paediatric surgical topics.  There may be a combination of 2 active stations (with examiners) and 1 static station (written responses to questions).

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

Students may access the University Health Practice, 61+ 08 8313 5050

Please read the MBBS Program Code of Conduct.