Course Coordinator: Professor Declan Kennedy
Phone: +61 8 8161 6398
Email: declan.kennedy@adelaide.edu.au
Location: University Department of Paediatrics, Women’s and Children’s Hospital

Academic Staff: Professor Jennifer Couper
Phone: +61 8 8161 6242
Email: jennifer.couper@adelaide.edu.au
Location: University Department of Paediatrics, Women’s and Children’s Hospital

Administrative Contact: Gemma Provis
Phone: +61 8 8161 6346
Email: gemma.provis@adelaide.edu.au
Location: University Department of Paediatrics, Women’s and Children’s Hospital

The course timetable for the  rotation is made available to students on the first day of the placement.

1	Knowledge 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	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	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	Knowledge of the emergency care of children, common surgical conditions, resuscitation procedures, competency in common procedures such as blood sampling, urine sample collection.
5	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	Knowledge of 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	Knowledge of the privacy issues that apply to children, proven ability to communicate and empathise with children and their families

There are no required resources

Essential reading

Practical Paediatrics   (7th ed, 2012)                             
ISBN: 9780443102806
Dist: Elsevier        
RRP:   $153.00                       

Paediatric Handbook   (2004)
Women’s and Children’s Hospital
Dist: Available from the Emergency Department
RRP:  $25.00 (folder), $15.00 (insert only)


Recommended reading

Paediatric Clinical Examination Made Easy   (5th ed revised, 2006)  
ISBN: 9780443103957
Dist: Elsevier                     
RRP: $ 47.00        

Great Ormond Street Colour Handbook of Paediatric Medicine and Surgery (2007)
ISBN: 9781874545279         
Dist: Woodslane Pty Ltd                
RRP: $ 120.00                         

Jones’ Clinical Paediatric Surgery (6th ed, 2008)                       
ISBN: 9781405162678
Dist: Wiley and Sons                      
RRP: $ 130.00                   

Illustrated Textbook of Paediatrics (4th ed, 2011)                               
ISBN: 9780723435655
Dist: Elsevier                     
RRP: $ 62.00

Paediatrics and Child Heath (3rd ed, 2011)                
ISBN: 9781405194747
Dist: Wiley                          
RRP: $77.95                                                                           

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


Further useful reading

Apley’s Concise System of Orthopaedics and Fractures   (3rd ed, 2005)          
ISBN: 9780340809846
Dist: Cengage                   
RRP: $87.95                                       

Lecture Notes on Diseases of the Ear, Nose and Throat  (10th ed rev, 2007)   
ISBN: 9781405145084      
Dist: Wiley & Sons                           
RRP: $49.95       

Nelson’s Essentials of Paediatrics      (6th ed, 2010) 
ISBN: 9781437706437
Dist: Elsevier                     
RRP: $ 104.00     

Vaughn and Ashbury’s General Ophthalmology (18th ed, 2011)                
ISBN: 9780071634205
Dist: McGraw-Hill Education Aust         
RRP: $ 100.00     

Lecture Notes – Paediatrics   (8th Ed, 2011)                     
ISBN: 9781405145091
Dist: Wiley & Sons           
RRP: $47.95                                         


Major text references

Nelson’s Textbook of Paediatrics (19th ed, 2011)                   
ISBN: 9781437707557
Dist: Elsevier   
RRP: $ 150.00     


Useful websites

Online Medelian Inheritance in Man (OMIM)
http://www.ncbi.nlm.nih.gov/Omim/

American Academy of Paediatrics
http://www.aap.org/ 

Online Lectures:      
https://curriculum.adelaide.edu.au/groups/5/course_notes_detail.asp?year=2010&case=149       

Formative MCQ’s in relation to lecture topics are available through MyUni:
https://myuni.adelaide.edu.au/

Spotting the Sick Child:
https://www.spottingthesickchild.com/   

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: •    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 •    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 circumstancesDeveloping 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.  

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.

Students are also expected to participate in at least three on-call evenings throughout their attachment.

Timing of Assessments:
The following provides details of the timing of the assessment processes, in chronological order for completion of the assessment tasks.

1.    End of Internship Supervisor Final Assessments:
Timing: Assessment forms titled ‘Summative Clinical Assessment” which are the Internship Supervisor Final Assessments are required for each of the three internships. They are due on the Friday at the completion of each internship.

2.    Observed Clinical Assessment:
Timing: In Week 6 of the Clinical Attachment in Paediatrics and Child Health.

3.    Log Book
Timing: Submission of the Log Book to the Clinical Studies Officer in the Department of Paediatrics is required by the last Friday of internship 3 of the Clinical Attachment in Paediatrics and Child Health.

4.    OSCE
Surgical OSCE:
Timing: The OSCE will be on the Friday morning of Week 9 of the Clinical Attachment in Paediatrics and Child Health.

Medical OSCE:
Timing: The OSCE will be on the Friday afternoon of Week 9 of the Clinical Attachment in Paediatrics and Child Health.

Lectures, seminars and tutorials are scheduled for Friday afternoons and three Wednesday mornings over the students’ 9 week attachment.  These sessions cover information regarding Paediatric medicine, Paediatric surgery, Child and Adolescent Mental Health & Paediatric Emergency Care.  The lecture topics are:

Paediatric Surgery
Surgical Quiz 1- Mr Sanjeev Khurana
The Acute Abdomen in Children-   Mr Sanjeev Khurana
Lumps and Bumps- Mr Chris Kirby
Neonatal Surgery- Dr Cathy Cord-Udy    
Surgical Quiz 2- Mr Sanjeev Khurana
Inguino-scrotal Pathology / Hypospadias- Mr Tony Sparnon        
Acute Infections of Bone and Joint-   Mr Phil Brook    
Principles of Fractures, Common Fractures of Upper & Lower Limbs- A/Prof Peter Cundy
Back Pain and Spinal Deformity-   A/Prof Peter Cundy
Neonatal Orthopaedics-   Mr Bruce Foster
Pain in the Hip & Knee Joint-   Mr Joff Middleton    
Lower Limb Development in Children / Bone Tumours- Dr Peter Viiret
ENT Lecture- Dr John Ling
Plastic Surgery- Dr Roger Woods
Neurosurgery Lecture- Mr Stephen Santoreneos

Paediatric Medicine
Asthma, Pneumonia, Bronchiolitis & Croup-   Dr Declan Kennedy
Audiology Lecture – Hearing Assessments-   Dr Tony Marciano
Physical & Sexual Abuse of Children-   Dr Jane Edwards
Gastroenteritis, Diarrhoea & Malabsorption- Dr Richard Couper
The Atopic & Allergic Child-  Dr Michael Gold/Dr Patrick Quinn
Childhood Immunisation- Dr Christina Boros
Heart Disease-  Dr Terry Robertson/Dr Malcolm Richardson
Diabetes and Obesity-  Professor Jennifer Couper    
Imaging 1-  Dr Tony Smith
Imaging 2- Dr Robyn Grant
Neurology Lecture-   Dr Nicholas Smith    
Genetic Counselling-  Dr Eric Haan
Acute and Chronic Renal Disorders- Dr Paul Henning/Dr Sam Crafter
Growth & Puberty-  Dr Jan Fairchild
Acute Leukemia and Major Clotting Disorders- A/Prof Tom Revesz
Paediatric Ophthalmology- Dr Theresa Casey    
Serious Infections (Sepsis, Meningitis, Osteomyelitis, UTI)-  Professor John Turnidge

Child and Adolescent Mental Health
Behavioural Disorders-   Prof Michael Sawyer
The Distressed Mother & Child: Perinatal & Infant
Mental Health & COPMI - Dr Ros Powrie
Mental Health in Indigenous Youth-    Dr Emma Hanieh
A Sick Child – What About the Family?-   Dr Simon Hein
Drugs, Alcohol and the Difficult Adolescent- Dr Ben Wells
A Depressed Adolescent. How Do I Know if it is Serious?- Dr Prue McEvoy

Paediatric Emergency Care
Resus4Kids Simulation Workshop- Dr Lesley Woodard-Knight/Leanne Stacy

Bedside Teaching Tutorials
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.

Extra small group teaching sessions
Each student will also attend one Plastering Teaching Session, one Pathology teaching session and one ICU teaching session throughout the 9 weeks, students will be split into small groups for these sessions.

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.

The predominant learning method for the MBBS Program is small group discovery learning.

Assessment Task	Assessment Type	Weighting	Learning Outcome(s) being addressed
Three Internship Supervisor Final Assessments	Summative	N/A (Submitted/Not Submitted)	1-7
Observed Clinical Assessment	Summative	10 marks	1-3
Medical OSCE	Summative	75 marks	1-7
Surgical OSCE	Summative	45 marks	4
Mental Health Attachment- iLab component	Summative	40 marks	5
Log Book	Compulsory Formative	N/A (Submitted/Not Submitted)

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.

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).

All assessment components must be submitted to the Clinical Studies Officer by the due date.

SELT forms will be given to each student on the last day of their attachment.  Students may also be asked to fill in SELT forms on a particular tutor or lecturer.  

An iLab evaluation form will be given to all students on the last day of their attachment.  

Students are encouraged to meet with the Clinical Studies Officer if they have any problems or queries while on their Paediatrics attachment.

Information regarding University and Hospital OH&S policies and Incident Reporting is given to each student on their Introductory Day.