Unit Guide

General Information

Unit convenor and teaching staff	Unit convenor and teaching staff Unit Convenor Stephney Whillier stephney.whillier@mq.edu.au Contact via 9850 9387 C5C 362 as requested via email co-convenor Ben Brown benjamin.brown@mq.edu.au Contact via 9850 6383 C5C 341
Credit points	Credit points 4
Prerequisites	Prerequisites Admission to MChiro and (CHIR311 or CHIR316 or (CHIR602 and CHIR603 and CHIR604 and CHIR605 and CHIR606 and CHIR607))
Corequisites	Corequisites
Co-badged status	Co-badged status
Unit description	Unit description This unit introduces you to common neurological and orthopaedic conditions. A variety of teaching methods are employed, from didactic lectures based on current evidence that are made available online, to tutorials that are underpinned by a social constructivist approach to building knowledge, using the discussion of case studies to develop diagnostic skill. You will develop competency in neurological and orthopaedic examination and in developing a differential diagnosis based on the patient’s signs and symptoms at clinical presentation. The knowledge and skills acquired during this unit are fundamental for diagnostic competence in chiropractic practice.

Important Academic Dates

Information about important academic dates including deadlines for withdrawing from units are available at https://www.mq.edu.au/study/calendar-of-dates

Learning Outcomes

On successful completion of this unit, you will be able to:

Demonstrate a sound competency in integrating and applying neuromusculoskeletal anatomy, physiology and pathology.
Perform the clinical neuromusculoskeletal history taking and examination competently
Show an ability to draw on their theoretical knowledge in order to tailor the physical examination to the clinical presentation of the patient and from this develop a differential diagnosis.
Develop strong clinical reasoning skills and the ability to diagnose conditions that are suitable or contraindicated in chiropractic care, including conditions of non-musculoskeletal origin
Use acquired knowledge to evaluate conditions, research these cases further using appropriate reference material and communicate findings
Participate in practical sessions in which the knowledge acquired in texts and lectures is applied in a group situation. They should be able to reason, question and communicate your understandings to each other and your tutors as they complete tasks set in the practicals
Develop a respect and empathy for patients, and an ethical and professional attitude to health care. In this regard, they should develop a commitment to remain informed and up-to-date in their profession

General Assessment Information

Attendance Requirements

A minimum of 80% attendance at tutorial classes is required in order to successfully complete this unit.

You must attend the class in which you are enrolled. You must not exchange your class time. In special circumstances, you may apply for requests regarding changes. These requests are to be submitted to the unit convener.

Examinations

The University Examination period is in the First Half of the 2015 from: 9^th June – 26^th June.

You are expected to present yourself for examination at the time and place designated in the University Examination Timetable. The timetable will be available in draft form approximately eight weeks before the commencement of the examinations and in final form approximately four weeks before the commencement of the examinations.

http://www.timetables.mq.edu.au/exam

The only exception to not sitting an examination at the designated time is because of documented illness or unavoidable disruption. In these circumstances you may wish to consider applying for disruption to studies. Information about the disruption to studies process is available at

http://students.mq.edu.au/student_admin/exams/disruption_to_studies/

If a supplementary examination is granted as a result of the disruption to studies process the examination will be scheduled after the conclusion of the official examination period. (Individual Faculties may wish to signal when the Faculty Supplementary exams are normally scheduled.)

NOTE: Supplementary exams will be set at a higher difficulty level than exams scheduled in the normal examination period. Supplementary exams may also be in a different format to the exam set in the normal examination period e.g. oral examination.

You are advised that it is Macquarie University policy not to set early examinations for individuals or groups of students. You are expected to ensure that you are available until the end of the teaching semester that is the final day of the official examination period.

Returning Assessment Tasks

Online quizzes will be automatically marked and returned for students to monitor their progress
The journal article review will be returned in the first tutorial of semester 2, and feedback will be given.
OSCE: Papers will not be returned. Marks will be incorporated into the final unit grade.
Examination: Papers will not be returned. Marks will be incorporated into the final unit grade.

Extensions and penalties

Extensions to assignments are at the discretion of the unit convenor. It is your responsibility to prove to the convenor that there has been unavoidable disruption. Marks will be deducted for late submissions in the absence of an approved extension.

Grades

Achievement of grades will be based on the following criteria:

High Distinction: provides consistent evidence of deep and critical understanding in relation to the learning outcomes. There is substantial originality and insight in identifying, generating and communicating competing arguments, perspectives or problem solving approaches; critical evaluation of problems, their solutions and their implications; creativity in application.

Distinction: provides evidence of integration and evaluation of critical ideas, principles and theories, distinctive insight and ability in applying relevant skills and concepts in relation to learning outcomes. There is demonstration of frequent originality in defining and analysing issues or problems and providing solutions; and the use of means of communication appropriate to the discipline and the audience.

Credit: provides evidence of learning that goes beyond replication of content knowledge or skills relevant to the learning outcomes. There is demonstration of substantial understanding of fundamental concepts in the field of study and the ability to apply these concepts in a variety of contexts; plus communication of ideas fluently and clearly in terms of the conventions of the discipline.

Pass: provides sufficient evidence of the achievement of learning outcomes. There is demonstration of understanding and application of fundamental concepts of the field of study; and communication of information and ideas adequately in terms of the conventions of the discipline. The learning attainment is considered satisfactory or adequate or competent or capable in relation to the specified outcomes.

Fail: does not provide evidence of attainment of all learning outcomes. There is missing or partial or superficial or faulty understanding and application of the fundamental concepts in the field of study; and incomplete, confusing or lacking communication of ideas in ways that give little attention to the conventions of the discipline. In addition a fail grade will be awarded in the event of inadequate tutorial attendance by the candidate, reflecting failure to complete the unit satisfactorily.

Sometimes it helps to ‘translate’ these descriptions into numbers. So, what we expect from you in this unit, in order for you to attain a specific grade, is outlined below:

NOTE: Each strand of the unit must have an overall passing grade

Assessment Tasks

Name	Weighting	Due
1	10%	continuous
2.	10%	Week 11, 18 May, by 5pm
3	20%	weeks 6 & 7
4	20%	Week 12 and 13
5	40%	TBA

1

Due: continuous
Weighting: 10%

Ten quizzes will be made available to students at the start of the semester which will be due at the end of the semester. The quiz questions will be based on lecture and tutorial readings, and will prepare students for the following week’s tutorial.

On successful completion you will be able to:

Demonstrate a sound competency in integrating and applying neuromusculoskeletal anatomy, physiology and pathology.
Show an ability to draw on their theoretical knowledge in order to tailor the physical examination to the clinical presentation of the patient and from this develop a differential diagnosis.
Use acquired knowledge to evaluate conditions, research these cases further using appropriate reference material and communicate findings

2.

Due: Week 11, 18 May, by 5pm
Weighting: 10%

Critical review of journal paper

Choose a randomised controlled clinical trial that addresses a neurological question that has been published in either 2014 or 2015.

Critically appraise the research article according to the criteria below obtained from the review:

Young JM & Solomon MJ (2009) How to critically appraise an article. Nature Clinical Practice Gastroenterology & Hepatology 6: 82-91.

See the link to this and other articles on the critical appraisal of journal articles on iLearn. This will be discussed in further depth in the lectures.

TEN QUESTIONS TO ASK WHEN CRITICALLY APPRAISING A RESEARCH ARTICLE.

Is the study question relevant?
Does the study add anything new?
What type of research question is being asked?
Was the study design appropriate for the research question?
Did the study methods address the most important potential sources of bias?
Was the study performed according to the original protocol?
Does the study test a stated hypothesis?
Were the statistical analyses performed correctly?
Do the data justify the conclusions?
Are there any conflicts of interest?

The review must be submitted electronically to ‘Turn-it-In’ via the iLearn website. Maximum Length: 4 pages

Font size 11, New Times Roman, 1.5 spacing.

On successful completion you will be able to:

Demonstrate a sound competency in integrating and applying neuromusculoskeletal anatomy, physiology and pathology.
Show an ability to draw on their theoretical knowledge in order to tailor the physical examination to the clinical presentation of the patient and from this develop a differential diagnosis.
Develop strong clinical reasoning skills and the ability to diagnose conditions that are suitable or contraindicated in chiropractic care, including conditions of non-musculoskeletal origin
Use acquired knowledge to evaluate conditions, research these cases further using appropriate reference material and communicate findings

3

Due: weeks 6 & 7
Weighting: 20%

OSCE: This will assess your competency in performing the neurological and orthopaedic examinations.

On successful completion you will be able to:

Perform the clinical neuromusculoskeletal history taking and examination competently
Show an ability to draw on their theoretical knowledge in order to tailor the physical examination to the clinical presentation of the patient and from this develop a differential diagnosis.
Develop strong clinical reasoning skills and the ability to diagnose conditions that are suitable or contraindicated in chiropractic care, including conditions of non-musculoskeletal origin
Participate in practical sessions in which the knowledge acquired in texts and lectures is applied in a group situation. They should be able to reason, question and communicate your understandings to each other and your tutors as they complete tasks set in the practicals
Develop a respect and empathy for patients, and an ethical and professional attitude to health care. In this regard, they should develop a commitment to remain informed and up-to-date in their profession

4

Due: Week 12 and 13
Weighting: 20%

OSCE: This will assess your competency in performing the neurological and orthopaedic examinations

On successful completion you will be able to:

Perform the clinical neuromusculoskeletal history taking and examination competently
Show an ability to draw on their theoretical knowledge in order to tailor the physical examination to the clinical presentation of the patient and from this develop a differential diagnosis.
Develop strong clinical reasoning skills and the ability to diagnose conditions that are suitable or contraindicated in chiropractic care, including conditions of non-musculoskeletal origin
Participate in practical sessions in which the knowledge acquired in texts and lectures is applied in a group situation. They should be able to reason, question and communicate your understandings to each other and your tutors as they complete tasks set in the practicals
Develop a respect and empathy for patients, and an ethical and professional attitude to health care. In this regard, they should develop a commitment to remain informed and up-to-date in their profession

5

Due: TBA
Weighting: 40%

FINAL EXAMINATION: This will cover the content of each of the strands for the entire semester. It tests your knowledge of the theory, and the ability to connect that knowledge to real life situations (e.g. case studies, clinical presentations). It will consist of a 3 hour written exam with multiple choice questions, short answer questions and case studies.

On successful completion you will be able to:

Demonstrate a sound competency in integrating and applying neuromusculoskeletal anatomy, physiology and pathology.
Show an ability to draw on their theoretical knowledge in order to tailor the physical examination to the clinical presentation of the patient and from this develop a differential diagnosis.
Use acquired knowledge to evaluate conditions, research these cases further using appropriate reference material and communicate findings

Delivery and Resources

Delivery mode

This unit is characterised by a moderate degree of flexibility. It incorporates a variety of learning tools and media. It will comprise:

Strand 1 - Orthopaedics

Strand 2 – Neurology

Total

Lectures

1-2 × 2 hour lectures per week

Lecture 1: Monday 3pm-5pm (E7B T2), weeks 1-12

Lecture 2: Wednesday 9am–11am (E7B T2), weeks 3-11

1-2 × 2 hour lectures per week

Lecture 1: Tuesday 9am-11 am, E7B T2, weeks 1-12

Lecture 2: Wednesday 9am–11am (E7B T2), weeks 1, 2, 12

6 hours per week, weeks 1-12

Tutorials

1 × 2 hour tutorial class per week, weeks 2 – 13

Thursday 9-11am or 11am-1pm (E5A 330 South Lab)

1 × 2 hour tutorial class per week, weeks 2 – 13

Wednesday 2-4, 4-6 (choose one) in (E5A 320 North Lab)

4 hours per week, weeks 2-13

Other

1-2 hours per week revision, self-instructional learning and readings

1 - 2 hours per week revision, self instructional learning and readings from the text

2 - 4 hours per week

Further details on class time and locations for this unit can be found by following the link below:

http://students.mq.edu.au/student_admin/timetables

Tutorials

You must attend the tutorial class in which you enrolled. Students must not exchange their class time. In special circumstances, you may request a specific change. These requests are to be submitted to the strand coordinator.

Attendance Requirements

If you miss your assigned tutorial in any week, you may request attendance at an alternative session, through written request and appropriate documentation to the unit convener. This allowance may be used on a maximum of 2 occasions.

Unit Web Page

You can log in to iLearn System via the link listed below:

https://ilearn.mq.edu.au/login/MQ/

All lecture materials will be posted on ilearn, and there is also a link to ECHO360 for audio or audiovisual (where available) recordings of the lectures.

Required and recommended resources

Strand 1: Orthopaedics

Notes are summarised under ‘Lectures’ on iLearn for CHIR 873

Required:

Magee D.J. (2013). Orthopaedic Physical Assessment. 6^th Edition. W.D Saunders, Philadelphia

Recommended Reading

Brukner P, Khan, K. (2011) Brukner & Khan's Clinical Sports Medicine. 4th Ed. McGraw-Hill Book Company Australia.
Souza TA. (1997) Differential Diagnosis for the Chiropractor. Aspen Publications.
Hammer W. 3^rd Ed. Functional Soft Tissue Examination & Treatment by Manual Methods. Jones and Barlett, Sudbury Massachusetts.
Evans RC. (2008) Illustrated Orthopaedic Physical Assessment. Mosby.

NOTE: Weekly tutorial case reports, questionnaires, and readings will be made available through iLearn.

Students will be required to complete weekly quizzes based on recent peer-reviewed journal articles that will be made available on iLearn.

Strand 2: Neurology

Required:

Blumenfeld H (2010) Neuroanatomy through Clinical Cases. 2^nd ed. Sinauer Associates Inc, Massachusetts. Distributed by Palgrave Macmillan, Victoria, Australia.

CHIR873 - Neurology Tutorial Course Manual – available at Co-op bookshop. Macquarie University Printery.

Recommended:

Gates P (2010) Clinical Neurology A Primer. Churchhill Livingstone Elsevier, Sydney, Australia
Krebs C et al (2012) Neuroscience in Lippincott’s Illustrated Reviews (Harvey RA Ed) LWW, USA
Kandel ER et al (2000) Principles of Neural Science, 4th ed. McGraw-Hill, New York.
Jull, GA et al (2008) Whiplash, headache, and neck pain: Research-based directions for physical therapies, 1^st ed. Churchill Livingstone: Elsevier, Edinburgh.
Olesen J et al (2006) The Headaches 3^rd ed. LWW, PA.
Souza TA (2005) Differential diagnosis and management for the chiropractor 3^rd ed. Jones & Bartlett Pub, Massachusetts.
Purves D et al (2012) Neuroscience 5^th ed. Sinauer Inc, USA
McCance KL et al (2010) Pathophysiology, The biologic basis for disease in adults and children Mosby, Elsevier, Canada
Bickley LS (2009) Bate’s Guide to Physical Examination and History Taking 10^th ed. Wolters Kluwer/Lippencott Williams & Wilkins, PA
Kiernan, JA (2009) Barr’s The Human Nervous System An Anatomical Viewpoint 9^th ed. Wolters Kluwer/LWW, PA
Haines, DE (2008) Neuroanatomy: An Atlas of Stuctures, Sections, and Systems 7^th ed. Wolters Kluwer/LWW, PA
Nolte, J (2009) The Human Brain: An Introduction to its Functional Anatomy 6^th ed. Mosby/Elsevier, PA

Required Diagnostic Equipment (Neurological Diagnosis Kit):

A diagnostic set with otoscope and ophthalmoscope (Welsh Allen series 97200-BI recommended - ~$515)
A tailor’s measuring tape
A 128 and 512Hz tuning fork (Al weighted)
Neurotips (no sewing pins or pinwheels allowed strictly by OHS/Biosafety regulations)
Large stem ear buds
Disposable tongue depressors
Tomahawk reflex hammer
Cotton wool

Unit Schedule

The Neurology Timetable:

Start Date of wk	Lecture (Tuesday, 9 – 11 am)	Lecture (Wednesday, 9-11am)		Tutorial (Wednesday 2 - 4, 4 - 6 pm)
23 Feb	Introduction to Clinical Neurology Pain	Nerve Tension Tests		None
2 Mar	Pain	Nerve Tension Tests and Mobilisations		Nerve Tension Tests and Mobilisations
9 Mar	Altered cognition Seizures			Nerve Tension Tests and Mobilisations
16 Mar	Psychiatric disorders			Neurological History Taking The Neuroexam: mental status
23 Mar	Sleep disorders			Neuroexam: mental status
30 Mar	Eye Presentations			Neuroexam: cranial nerves
7 April – 17 April: Mid-semester Break
20 April	Hearing and Balance Presentations		OSCE
27 April	Cerebrovascular Disease and Brain Neoplasms		Neuroexam: cranial nerves
4 May	Lesions of the Spinal Cord and Localisation of the Lesion		Neuroexam: motor
11 May	Lesions of the Spinal Cord and Localisation of the Lesion		Neuroexam: motor
18 May	Common Lesions of the NS		Neuroexam: sensory
25 May	Common Lesions of the NS	Common Lesions of the NS	Neuroexam: sensory, examination of peripheral nerves
1 June			OSCE

Orthopaedics Timetable

WEEK

LECTURE 1

LECTURE 2

Tutorial

Introduction to Orthopaedics

(B. Brown)

Neurology Lecture

No Tutorial

Lower Back Pain due to Serious pathology

(B. Brown)

Neurology Lecture

Orthopaedic Assessment of the Lumbar Spine – Part I

Lower Back Pain with Associated Radiculopathy I

(B. Brown)

Lower Back Pain with Associated Radiculopathy II

(B.Brown)

Orthopaedic Assessment of the Lumbar Spine – Part II

Lumbar Spine Spondylolysis and Spondylolisthesis (B.Brown)

Lumbar Spine Spondylosis and Stenosis

(B.Brown)

Orthopaedic assessment of Lumbar Spine Stability, and Generalised Hypermobility

Non-Specific Lower Back Pain

(B.Brown)

Lumbar Instability and Hypermobility

(B.Brown)

Orthopaedic Assessment of the Sacroiliac Joint and Coccyx

Disorders of the sacroiliac Joint and Coccyx

(B.Brown)

Leg Length Discrepancy (B.Brown)

OSCE 1

Mid Semester Break April 7^th – April 17^th, 2015

Soft tissue causes of hip pain

(M.Pribicevic)

Myofascial & neural causes of hip pain (M.Pribicevic)

Orthopaedic Assessment of the Hip - Part I

Osteological Causes of Hip Pain

(M.Pribicevic)

Orthopaedic Assessment of the Older Patient

(B.Brown)

Orthopaedic Assessment of the Hip - Part II and Knee - Part I

Meniscal and cruciate ligament injuries

Collateral injuries, rotatory instability and myofascial disorders of the knee

Orthopaedic Assessment of the Knee – Part II

Patellofemoral and growth plate disorders of the knee

Injuries of the lower leg and ankle

(B.Brown)

Orthopaedic Assessment of the Foot and Ankle - Part I

Joint & ligament disorders of the ankle

(B.Brown)

Disorders of the mid-foot, forefoot and toes (B.Brown)

Orthopaedic Assessment of the Foot and Ankle - Part II

Review Lecture (B.Brown)

Neurology Lecture

OSCE 2

No Lecture

No Tutorial

Policies and Procedures

Macquarie University policies and procedures are accessible from Policy Central. Students should be aware of the following policies in particular with regard to Learning and Teaching:

Academic Honesty Policy http://mq.edu.au/policy/docs/academic_honesty/policy.html

Assessment Policy http://mq.edu.au/policy/docs/assessment/policy.html

Grading Policy http://mq.edu.au/policy/docs/grading/policy.html

Grade Appeal Policy http://mq.edu.au/policy/docs/gradeappeal/policy.html

Grievance Management Policy http://mq.edu.au/policy/docs/grievance_management/policy.html

Disruption to Studies Policy http://www.mq.edu.au/policy/docs/disruption_studies/policy.html The Disruption to Studies Policy is effective from March 3 2014 and replaces the Special Consideration Policy.

In addition, a number of other policies can be found in the Learning and Teaching Category of Policy Central.

Student Code of Conduct

Macquarie University students have a responsibility to be familiar with the Student Code of Conduct: https://students.mq.edu.au/support/student_conduct/

Results

Results shown in iLearn, or released directly by your Unit Convenor, are not confirmed as they are subject to final approval by the University. Once approved, final results will be sent to your student email address and will be made available in eStudent. For more information visit ask.mq.edu.au.

Student Support

Macquarie University provides a range of support services for students. For details, visit http://students.mq.edu.au/support/

Learning Skills

Learning Skills (mq.edu.au/learningskills) provides academic writing resources and study strategies to improve your marks and take control of your study.

Student Services and Support

Students with a disability are encouraged to contact the Disability Service who can provide appropriate help with any issues that arise during their studies.

Student Enquiries

For all student enquiries, visit Student Connect at ask.mq.edu.au

IT Help

For help with University computer systems and technology, visit http://informatics.mq.edu.au/help/.

When using the University's IT, you must adhere to the Acceptable Use Policy. The policy applies to all who connect to the MQ network including students.

Graduate Capabilities

PG - Capable of Professional and Personal Judgment and Initiative

Our postgraduates will demonstrate a high standard of discernment and common sense in their professional and personal judgment. They will have the ability to make informed choices and decisions that reflect both the nature of their professional work and their personal perspectives.