The University of Adelaide
Course Outlines

MEDIC ST 5014AHO - Anaesthesia, Pain Medicine & Intensive Care V Pt1

Teaching Hospitals - Semester 1 - 2022

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. Some students will have the opportunity to undertake their training for an extended period of time in a rural or remote setting.

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  • General Course Information
    Course Details
    Course Code MEDIC ST 5014AHO
    Course Anaesthesia, Pain Medicine & Intensive Care V Pt1
    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 Based on attendance, knowledge, participation in discussions and short projects
    Course Staff

    Course Coordinator: Jeremy Brammer

    Course Co-ordinator
    Dr Jeremy Brammer
    Email: Jeremy.Brammer@sa.gov.au

    Joint course co-ordinator (ICU)
    A/Prof Mary White
    Email: Mary.White2@sa.gov.au

    RAH Anaesthetics contact:
    Dr Julia Coldrey
    Email: Julia.Coldrey@sa.gov.au

    RAH ICU Contact:
    A/Prof Mary White
    Email: Mary.White2@sa.gov.au

    Palliative Care Contact:
    Professor Greg Crawford
    Email: gregory.crawford@adelaide.edu.au

    The Queen Elizabeth Hospital contact:
    Dr Thava Visvanathan
    Email: thava1@optusnet.com.au

    Lyell McEwin Hospital contact:
    Dr Lynda D’Souza
    Email: Lynda.D'Souza@health.sa.gov.au
    Course Timetable

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

    The course timetable for the APIC rotation will vary dependent on which hospital the placement is being undertaken.  Timetables will made available to students on the first day of the rotation.


  • Learning Outcomes
    Course Learning Outcomes
    Competencies expected of a fifth-year medical student
    1. Conduct a preoperative assessment
    2. Identify significant co-morbidities and outline strategies for perioperative investigation, optimisation and management
    3. Understand the principles of perioperative patient monitoring and recognition of early deterioration
    4. Overview of anaesthesia principles, including emergency anaesthesia
    5. Application of clinical pharmacology to safely deliver local anaesthesia to patients.
    6. Utilise difficult airway algorithm that incorporates professional boundaries
    7. Perform advanced life support skills, with effective use of airway aids
    8. Use a framework to diagnose and manage common post-surgical problems
    9. Develop an approach to the management of critically ill patients including 
      a. Essentials of identification, triage and management of critically ill patients
      b. Principles of life-support and monitoring systems
    10. Assessment of pain in relation to clinical diagnosis, classification and response to therapy
    11. Knowledge of the pharmacology of drugs commonly used in pain management
    12. Familiarity with drug and non-drug techniques commonly used in pain management
    13. Develop pain management strategies required to competently fulfil the role of an intern.
    14. Outline principles and professional medical responsibilities in patient palliative care
    15. Learn effective interaction with multi-professional teams involved in the APIC disciplines
    16. Practice the APIC disciplines according to ethical principles.
    17. Utilise advanced communication techniques in difficult and challenging staff and patient encounters
    University Graduate Attributes

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

    University Graduate Attribute Course Learning Outcome(s)

    Attribute 1: Deep discipline knowledge and intellectual breadth

    Graduates have comprehensive knowledge and understanding of their subject area, the ability to engage with different traditions of thought, and the ability to apply their knowledge in practice including in multi-disciplinary or multi-professional contexts.

    		 All of the above

    Attribute 2: Creative and critical thinking, and problem solving

    Graduates are effective problems-solvers, able to apply critical, creative and evidence-based thinking to conceive innovative responses to future challenges.

    		 All of the above

    Attribute 3: Teamwork and communication skills

    Graduates convey ideas and information effectively to a range of audiences for a variety of purposes and contribute in a positive and collaborative manner to achieving common goals.

    		 All of the above

    Attribute 4: Professionalism and leadership readiness

    Graduates engage in professional behaviour and have the potential to be entrepreneurial and take leadership roles in their chosen occupations or careers and communities.

    		 All of the above

    Attribute 5: Intercultural and ethical competency

    Graduates are responsible and effective global citizens whose personal values and practices are consistent with their roles as responsible members of society.

    		 All of the above

    Attribute 6: Australian Aboriginal and Torres Strait Islander cultural competency

    Graduates have an understanding of, and respect for, Australian Aboriginal and Torres Strait Islander values, culture and knowledge.

    		 TBA

    Attribute 7: Digital capabilities

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

    		 TBA

    Attribute 8: Self-awareness and emotional intelligence

    Graduates are self-aware and reflective; they are flexible and resilient and have the capacity to accept and give constructive feedback; they act with integrity and take responsibility for their actions.

    		 All of the above
  • Learning Resources
    Required Resources
    N/A
    Recommended Resources
    Pain:
    •    Acute Pain Management: Scientific Evidence 3rd edition, 2010: see http://www.anzca.edu.au/fpm/resources/books-and-publications
    •    Macintyre and Schug, Acute Pain Management: a practical guide, WB Saunders, 3rd edition 2007
    •    Therapeutic Guidelines: Palliative Care: available via the University of Adelaide library
    •    Australian Medicines Handbook: available via the University of Adelaide library

    Anaesthesia:
    •    Introductory anaesthetics textbook such as:
    o    Gwinnutt, Lecture Notes: Clinical Anaesthesia, 5th edition, 2016
     
    Online Learning
    Learning resources are listed on the MyUni course site.
  • Learning & Teaching Activities
    Learning & Teaching Modes
    Core teaching process for ICU includes:
    1.    Small and large group teaching sessions ie. lectures and tutorials
    2.    Skills sessions (simulator sessions)
    3.    Case presentations
    4.    Clinical attachments with ward rounds
    5.    Self-directed study
    6.    Presentation of ICU related topics

    The pain component learning is delivered via:
    1.    Lectures/Workshops
    2.    Clinical attachments to acute pain, chronic pain and palliative care
    3.    Tutorials
    4.    Group work and group presentation
    5.    Case based discussion of chronic pain and palliative care
    6.    Self-directed learning

    The anaesthetics teaching and learning modes include:
    1.   Lectures
    2.   Small group discussion / Problem Based Learning sessions
    3.   Clinical attachments in theatre, OPD and recovery
    4.   Simulator sessions
    5.   Self-directed learning
    6.   Presentation of Anaesthesia related topics.
    Workload

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

    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 but does not include after hours call.
    Learning Activities Summary
    For all components, students are expected to attend all clinical rounds and rostered tutorials and participate actively in these.

    Anaesthetics
    All materials required for the course an be accessed via MyUni

    Pain
    Students are expected to complete the recommended readings:
    1.    Revisit 4th year lectures on pain and analgesics
    2.    Macintyre and Schug – Acute Pain Management
    a.    Chapter 3 – Assessment of pain
    b.    Chapter 4 – pharmacology of opioids
    c.    Chapter 6 – non-opioid and adjuvant analgesic drugs
    d.    Chapter 7 – routes of systemic opioid administration
    e.    Chapter 8 – patient-controlled analgesia
    f.    Chapter 9 – epidural analgesia
    g.    Chapter 12 – acute neuropathic pain
    h.    Chapter 14 – elderly, opioid-tolerant and substance abuse patients
    3.    Therapeutic Guidelines – Palliative Care
    a.    Chapter – Getting to know your drugs
    b.    Chapter – Pain
    4.    Macintyre PE, Loadsman JA, Scott DA. Opioids, ventilation and acute pain management. Anaesth Intensive Care. 2011 Jul;39(4):545-58
    5.    Coldrey JC, Upton RN, Macintyre PE. Advances in analgesia in the older patient. Best Pract Res Clin Anaesthiol. 2011 Sep; 25(3):367-78
    6.    Huxtable CA, Roberts LJ, Somogyi AA, Macintyre PE. Acute pain management in opiod-tolerant patients: a growing challenge. Anaesth Intensive Care. 2011 Sep;39(5):804-23
    Specific Course Requirements
    N/A
  • 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 Outcomes Assessed
    On-line quizzes during rotation Formative and Summative 20% All
    End of rotation anaesthesia project (wk 2) Summative 32% 1 - 8
    ICU placement participation and project Formative and Summative 32% 3, 7, 9, 15 - 17
    Pain case discussion end of week 3 Summative 16% 9 - 12, 15 - 17

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

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

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

    Academic Progression Requirements
    Progression from one year to the next in the MBBS is dependent on the student successfully completing a compulsory annual examination course in which a full year’s learning is assessed.

    To successfully complete the MEDIC ST 5000AHO and MEDIC ST 5000BHO Fifth Year MBBS Examination Part 1 and Part 2 courses, the student must pass the end of year examinations and have successfully completed all year level component courses (24 units).

    IF a student fails the compulsory examination course no passing grade will be received for any core medical studies courses.

    IF a student has not completed all required MEDIC ST units of the year they must successfully complete an appropriate remedial course of the same or greater value as specified in Term 4 of the same academic year.

    Assessment Related Requirements
    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.

    The University has developed a Scope of Practice document which outlines appropriate activities for Year 5 students. Students should be familiar with this document, and adhere to its guidelines. The document can be found in MyUni and here.
    Assessment Detail
    Pain and Palliative Care
    1.    Attendance at and participation in clinical rounds and tutorials
    2.    MCQ paper based on material covered in acute pain, chronic pain and pharmacology lectures in year 4. 
    3.    Group discussion of pain cases which will provided at the start of the rotation - students will be assessed on their contribution to these cases and are expected to have prepared appropriately. Additional questions may be asked by the facilitator.
    4.    Communication workshop/simulation for palliative care.

    Anaesthesia
    1.    Attendance at and participation in all rostered clinical activities
    2.    Active participation in PBL sessions and completion of quizzes that relate to each PBL.
    3.    Completion of all on line learning tasks on MyUni
    4.    Presentation of a topic related to anaesthesia at the end of the anaesthesia component of your rotation.  Topics will be provided by your local hospital coordinator.


    ICU
    1.    Professional behaviour
    2.    Participation in clinical activities
    a.    Attendance, including out of hours (minimum 95% attendance required to pass rotation)
    b.    Actively seeks learning opportunities
    c.    Contributes to patient discussion
    3.    Medical competence
    a.    Thorough history and physical examination skills
    b.    Concise and accurate case presentations
    4.    Theoretical knowledge
    a.    Good knowledge base with ability to apply to clinical situations
    5.    ICU presentation.


    Submission
    All submissions can be made via 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 Access Adelaide.

    Submission details will be outlined at the beginning of the attachment.
  • Student Feedback

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

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

    The MBBS Program has a regular program of evaluation.  In addition, student representatives are appointed to MBBS committees and are encouraged to report on issues of importance to students.
  • Student Support
    Students may access the University Health Practice, 61+ 08 83135050  http://www.adelaide.edu.au/student/health/

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

    This section contains links to relevant assessment-related policies and guidelines - all university policies.

    Please read the MBBS Program Code of Conduct
  • 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’s disciplinary procedures.

The University of Adelaide is committed to regular reviews of the courses and programs it offers to students. The University of Adelaide therefore reserves the right to discontinue or vary programs and courses without notice. Please read the important information contained in the disclaimer.
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