Students

CHIR919 – Clinical Management

2016 – S2 Day

General Information

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Unit convenor and teaching staff Unit convenor and teaching staff Unit Co-Convener
Rosemary Giuriato
Contact via rosemary.giuriato@mq.edu.au
Unit Co-Convener
Curtis Rigney
Contact via curtis.rigney@mq.edu.au
C5C 367
Thursday 9-11 or by appointment
Lecturer
Matthew Fernandez
Lecturer
Hazel Jenkins
Tutor
Melissa Tan
Tutor
Lucinda Slavin
Lecturer
Suzanne Saks
Contact via suzanne.saks@mq.edu.au
Tutor
Farouk Badawi
Contact via farouk.badawi@mq.edu.au
Tutor
Jakob Dolan
Contact via jakob.dolan@mq.edu.au
Tutor
Melinda Brookes
Contact via melinda.brookes@mq.edu.au
Lead Rehab Tutor
Kym Abbott
Credit points Credit points
4
Prerequisites Prerequisites
CHIR873 and CHIR916 and CHIR918
Corequisites Corequisites
CHIR874 and CHIR917
Co-badged status Co-badged status
Unit description Unit description
There are three areas of focus within this unit. Clinical reasoning skills are enhanced through experiential case presentations. This focus will allow the students to formulate clinical decisions based on the integrated knowledge gained from the varied clinical sciences and from the analyses learned from previous units. Another focus is patient management through active care and rehabilitation of the spine; rehabilitation of the extremities is introduced. The third focus is on preparation for clinic internship.

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:

  • Determine differential diagnoses based on historical, physical, functional information as well as information from special investigations
  • Construct an appropriate approach to a patient interview and determine appropriate investigations based on individual patient needs
  • Demonstrate appropriate use and performance of post-isometric relaxation
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise
  • Further develop research skills
  • Undertake a junior internship period meeting assessments relating to the operations of the clinic systems

General Assessment Information

Examination(s)

You are expected to present yourself for examination at the time and place designated in the University Examination Timetable. 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 Special Consideration. Information about unavoidable disruption and the special consideration process is available at Policy Central: http://www.mq.edu.au/policy/

If a Supplementary Examination is granted as a result of the Special Consideration process the examination will be scheduled after the conclusion of the official examination period. You are advised that it is Macquarie University policy not to set early examinations for individuals or groups of students. All students are expected to ensure that they are available until the end of the teaching semester, that is, the final day of the official examination period.

Extensions and penalties       

Extensions to assignments is at the discretion of the unit convener. It is the responsibility of the student to prove to the convener that there has been unavoidable disruption. If accepted, marks will be deducted for late submissions in the absence of an approved extension.

Returning Assessment Tasks                                                                                                                         

1. The results of the first practical will be posted within 10 working days and will be returned to the student

2. Assignment: Results will be posted and returned by Week 10. General feedback will be given during lecture and tutorial time

3. Case management results will be posted within 10 working days of completion.

4. Jr. Internship will involve regular and rapid feedback.

5. Group project results will be posted within 10 working days of completion.

6. Practice Assessment: Results will be posted during the exam period.

7. OSCE results will be made available on iLearn.

8. Examination: Papers will not be returned. Marks will be incorporated into the final unit grade. Results will be posted after the exam period

Assessment Tasks

Name Weighting Due
Midterm Rehab Practical 10% week 7
Assignment 1 10% week 7
Case Management 10% Week 7
Junior Internship 15% Ongoing
Group Presentation 5% Week 9
Practical Assessment 2 15% week 13
Clinical Competency Exam 0% week 13
Rehab Theory Final Exam 15% Exam Period
Clinic Prep Theory Examination 20% Exam Period

Midterm Rehab Practical

Due: week 7
Weighting: 10%

Assessment of understanding and performance of Post-isometric Relaxation and Sensory Motor Stimulation


On successful completion you will be able to:
  • Demonstrate appropriate use and performance of post-isometric relaxation
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise

Assignment 1

Due: week 7
Weighting: 10%

Will assess a student’s ability to document procedures, perform and interpret functional assessments, and diagram a rational aetiology.  A detailed management plan will be developed and presented. The assignment will also assess a student’s knowledge of anatomy and muscle function.


On successful completion you will be able to:
  • Demonstrate appropriate use and performance of post-isometric relaxation
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise

Case Management

Due: Week 7
Weighting: 10%

Will occur during the Wednesday lecture and will be a written assessment related to the process of making a diagnosis and developing a management plan.  Attendance is mandatory.


On successful completion you will be able to:
  • Determine differential diagnoses based on historical, physical, functional information as well as information from special investigations
  • Construct an appropriate approach to a patient interview and determine appropriate investigations based on individual patient needs

Junior Internship

Due: Ongoing
Weighting: 15%

You will participate in 20 hours in one of the Department’s clinics in the role as a junior intern. Attendance is mandatory. Punctuality, personal cleanliness and appropriate dress, as well as appropriate participation are also mandatory. Students will complete both reception duties in addition to observing senior interns whilst delivering treatment. During this internship period, every intern must competently complete the 'Consent Clinical Assessment' task, vitals, and completion of an evidence based questionnaire task.


On successful completion you will be able to:
  • Determine differential diagnoses based on historical, physical, functional information as well as information from special investigations
  • Construct an appropriate approach to a patient interview and determine appropriate investigations based on individual patient needs
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise
  • Undertake a junior internship period meeting assessments relating to the operations of the clinic systems

Group Presentation

Due: Week 9
Weighting: 5%

Students will assign themselves to a group to research and present assessment and management of common neuromusculoskeletal conditions.


On successful completion you will be able to:
  • Further develop research skills

Practical Assessment 2

Due: week 13
Weighting: 15%

Comprehensive assessment of rehab skills (assessment and management).


On successful completion you will be able to:
  • Demonstrate appropriate use and performance of post-isometric relaxation
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise

Clinical Competency Exam

Due: week 13
Weighting: 0%

Integrated assessment involving knowledge from orthopaedics, neurology, physical examination, functional assessment, technique, and rehabilitation. This assessment requires a passing grade to continue into clinic. This assessment is a Pass / Fail assessment


On successful completion you will be able to:
  • Determine differential diagnoses based on historical, physical, functional information as well as information from special investigations
  • Construct an appropriate approach to a patient interview and determine appropriate investigations based on individual patient needs
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise

Rehab Theory Final Exam

Due: Exam Period
Weighting: 15%

Assessment of understanding of rehab principles


On successful completion you will be able to:
  • Determine differential diagnoses based on historical, physical, functional information as well as information from special investigations
  • Construct an appropriate approach to a patient interview and determine appropriate investigations based on individual patient needs
  • Demonstrate appropriate use and performance of post-isometric relaxation
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise

Clinic Prep Theory Examination

Due: Exam Period
Weighting: 20%

Assessment of principles taught in the Clinic Prep component


On successful completion you will be able to:
  • Determine differential diagnoses based on historical, physical, functional information as well as information from special investigations
  • Construct an appropriate approach to a patient interview and determine appropriate investigations based on individual patient needs
  • Undertake a junior internship period meeting assessments relating to the operations of the clinic systems

Delivery and Resources

Delivery mode

Will be comprised of a combination of face-to-face lectures, pre-recorded lectures, self-directed learning, and hands-on tutorials:

1. 1 x two hour rehabilitation lecture per week

2. 1 x one hour clinical management lecture per week

3. 2 x two hour tutorials/practicals per week; 1 tutorial for rehabilitation, 1 tutorial for clinical management

4. 20 hours of junior internship during the mid-semester break

5. 2-3 hours per week self instructional learning

Class times and locations   

Lectures:  will be held in

L1; Wednesday 1-2pm in C5C T2 (Forum)

L2; Friday 10-12 in  C5C 230 (Forum)

Monday Tutorials (T1)held in E5A 330 & 340; 9-11 or 11-1pm

Wednesday Tutorials (T2): held in E5A 330 & 340; 2-4 or 4-6pm

NB: Check with the University’s timetable webpage to confirm room locations.

IMPORTANT: No tutorial changes after week 2

 

Required and recommended resources

  • Required texts:

- Liebenson. Rehabilitation of the Spine: a practitioner’s manual 2nd ed. Raven Press

- Beirman. Cases in the differential diagnosis for physical and manipulative therapists

ISBN: 9780729539975

  • Required Course Notes: (available in co-op)

- CHIR919 Workbook

  • Recommended texts:

- Morris. Low Back Pain: Integrated. McGraw-hill

- 2014 Department of Chiropractic Clinic Manual

Unit Schedule

CHIR119 Clinical Management 2016 (Subject to change)

WEEK

TUTORIAL 1  REHAB (Mon)

LECTURE 1

REASONING (Tue)

TUTORIAL 2

REASONING (Tue)

LECTURE 2

REHAB (Fri)

Week 1

1-5/8

Revision, Length PIR

Unit Intro/ scope of clinical management

No Tutorial

 

PNF/PIR

(Chapter 19)

CTR

Week 2

8-12/8

Length/PIR

The geriatric patient 1

Intro to tutorial format

Case 1

Preparation for case 2

Spinal Loading

(Chapter 15)

MF

Week 3

15-19/8

Length/PIR

The geriatric patient 2

Case 2

Nerve Tension

(Chapter 20)

MF

Week 4

22-26/8

 

Length/PIR

 

The geriatric patient 3

Case 2

 

Written communication

Sensory Motor Stim./Management

(Chapter 22)   CTR

Week 5

29/8-2/9

SMS

Clinic

Case 3

Exercise Science

 

MF

Week 6

5-9/9

 

SMS Plus

Assessing Mental status 1

Case 4/ Professionalism

Integrity

Spinal Stabilization

(Chapters 25 & 26)

MF

Week 7

12-16/9

 

PIR/SMS

Management Plan

Assessing Mental status 2

Case 5 Individual work

Strength & Fitness

 

MF

break

Clinic Rotations

Clinic Rotations (cte)

Clinic Rotations

Clinic Rotations

Week 8

3-7/10

No tutorial

 

Labour Day

The paediatric patient 1

Working with paediatric patients

Case 6

Cervical/Thoracic Rehab

HJ

Week 9

10-14/10

Exercise Therapy/

Core Stab

 

The paediatric patient 2

Case 6

Group Presentations

 

CTR

Week 10

17-21/10

Exercise Therapy/

Cervical/Thoracic

The paediatric patient 3

Case 7

Group Presentations

 

CTR

Week 11

24-28/10

Exercise Therapy/

Core Stab

The pregnant patient

Case 7

Group Presentations

 

CTR

Week 12

31/10-4/11

Revision

Revision

OSCE preparation

Group Presentations

CTR

Week 13

7-11/11

Final Practical

OSCE

OSCE

(ortho, neuro, x-ray, physical, functional, technique)

Revision

CTR

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

New Assessment Policy in effect from Session 2 2016 http://mq.edu.au/policy/docs/assessment/policy_2016.html. For more information visit http://students.mq.edu.au/events/2016/07/19/new_assessment_policy_in_place_from_session_2/

Assessment Policy prior to Session 2 2016 http://mq.edu.au/policy/docs/assessment/policy.html

Grading Policy prior to Session 2 2016 http://mq.edu.au/policy/docs/grading/policy.html

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

Complaint Management Procedure for Students and Members of the Public http://www.mq.edu.au/policy/docs/complaint_management/procedure.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.

In addition to the code of conduct as outlined in the Department's Clinic Manual, all student interns are bound by the Code of Conduct as outlined by the Chiropractic Board of Australia (CBA) whilst in attendance in the University Clinics http://www.chiropracticboard.gov.au/Codes-guidelines/Code-of-conduct.aspx

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://www.mq.edu.au/about_us/offices_and_units/information_technology/help/

When using the University's IT, you must adhere to the Acceptable Use of IT Resources 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.

This graduate capability is supported by:

Learning outcomes

  • Determine differential diagnoses based on historical, physical, functional information as well as information from special investigations
  • Construct an appropriate approach to a patient interview and determine appropriate investigations based on individual patient needs
  • Demonstrate appropriate use and performance of post-isometric relaxation
  • Further develop research skills
  • Undertake a junior internship period meeting assessments relating to the operations of the clinic systems

Assessment tasks

  • Midterm Rehab Practical
  • Assignment 1
  • Case Management
  • Junior Internship
  • Group Presentation
  • Practical Assessment 2
  • Clinical Competency Exam
  • Rehab Theory Final Exam
  • Clinic Prep Theory Examination

PG - Discipline Knowledge and Skills

Our postgraduates will be able to demonstrate a significantly enhanced depth and breadth of knowledge, scholarly understanding, and specific subject content knowledge in their chosen fields.

This graduate capability is supported by:

Learning outcomes

  • Determine differential diagnoses based on historical, physical, functional information as well as information from special investigations
  • Construct an appropriate approach to a patient interview and determine appropriate investigations based on individual patient needs
  • Demonstrate appropriate use and performance of post-isometric relaxation
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise
  • Further develop research skills
  • Undertake a junior internship period meeting assessments relating to the operations of the clinic systems

Assessment tasks

  • Midterm Rehab Practical
  • Assignment 1
  • Case Management
  • Junior Internship
  • Group Presentation
  • Practical Assessment 2
  • Clinical Competency Exam
  • Rehab Theory Final Exam
  • Clinic Prep Theory Examination

PG - Critical, Analytical and Integrative Thinking

Our postgraduates will be capable of utilising and reflecting on prior knowledge and experience, of applying higher level critical thinking skills, and of integrating and synthesising learning and knowledge from a range of sources and environments. A characteristic of this form of thinking is the generation of new, professionally oriented knowledge through personal or group-based critique of practice and theory.

This graduate capability is supported by:

Learning outcomes

  • Determine differential diagnoses based on historical, physical, functional information as well as information from special investigations
  • Construct an appropriate approach to a patient interview and determine appropriate investigations based on individual patient needs
  • Demonstrate appropriate use and performance of post-isometric relaxation
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise
  • Further develop research skills
  • Undertake a junior internship period meeting assessments relating to the operations of the clinic systems

Assessment tasks

  • Midterm Rehab Practical
  • Assignment 1
  • Case Management
  • Junior Internship
  • Group Presentation
  • Practical Assessment 2
  • Clinical Competency Exam
  • Rehab Theory Final Exam
  • Clinic Prep Theory Examination

PG - Research and Problem Solving Capability

Our postgraduates will be capable of systematic enquiry; able to use research skills to create new knowledge that can be applied to real world issues, or contribute to a field of study or practice to enhance society. They will be capable of creative questioning, problem finding and problem solving.

This graduate capability is supported by:

Learning outcomes

  • Determine differential diagnoses based on historical, physical, functional information as well as information from special investigations
  • Construct an appropriate approach to a patient interview and determine appropriate investigations based on individual patient needs
  • Demonstrate appropriate use and performance of post-isometric relaxation
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise
  • Further develop research skills
  • Undertake a junior internship period meeting assessments relating to the operations of the clinic systems

Assessment tasks

  • Midterm Rehab Practical
  • Assignment 1
  • Case Management
  • Junior Internship
  • Group Presentation
  • Practical Assessment 2
  • Clinical Competency Exam
  • Rehab Theory Final Exam
  • Clinic Prep Theory Examination

PG - Effective Communication

Our postgraduates will be able to communicate effectively and convey their views to different social, cultural, and professional audiences. They will be able to use a variety of technologically supported media to communicate with empathy using a range of written, spoken or visual formats.

This graduate capability is supported by:

Learning outcomes

  • Determine differential diagnoses based on historical, physical, functional information as well as information from special investigations
  • Construct an appropriate approach to a patient interview and determine appropriate investigations based on individual patient needs
  • Demonstrate appropriate use and performance of post-isometric relaxation
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise
  • Further develop research skills
  • Undertake a junior internship period meeting assessments relating to the operations of the clinic systems

Assessment tasks

  • Midterm Rehab Practical
  • Assignment 1
  • Case Management
  • Junior Internship
  • Group Presentation
  • Practical Assessment 2
  • Clinical Competency Exam

PG - Engaged and Responsible, Active and Ethical Citizens

Our postgraduates will be ethically aware and capable of confident transformative action in relation to their professional responsibilities and the wider community. They will have a sense of connectedness with others and country and have a sense of mutual obligation. They will be able to appreciate the impact of their professional roles for social justice and inclusion related to national and global issues

This graduate capability is supported by:

Learning outcomes

  • Determine differential diagnoses based on historical, physical, functional information as well as information from special investigations
  • Construct an appropriate approach to a patient interview and determine appropriate investigations based on individual patient needs
  • Demonstrate appropriate use and performance of post-isometric relaxation
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise
  • Further develop research skills
  • Undertake a junior internship period meeting assessments relating to the operations of the clinic systems

Assessment tasks

  • Midterm Rehab Practical
  • Assignment 1
  • Case Management
  • Junior Internship
  • Group Presentation
  • Practical Assessment 2
  • Clinical Competency Exam
  • Rehab Theory Final Exam
  • Clinic Prep Theory Examination

Changes from Previous Offering

No changes from previous offering

Disruption to Study Policy

Serious and unavoidable disruption: The University classifies a disruption as serious and unavoidable if it:

  • could not have reasonably been anticipated, avoided or guarded against by the student; and
  • was beyond the student's control; and
  • caused substantial disruption to the student's capacity for effective study and/or completion of required work; and
  • occurred during an event critical study period and was at least three (3) consecutive days duration, and/or
  • prevented completion of a final examination.

 

Students with a pre-existing disability/health condition or prolonged adverse circumstances may be eligible for ongoing assistance and support.  Such support is governed by other policies and may be sought and coordinated through Campus Wellbeing and Support Services.

 

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.)

If you are granted a supplementary exam via the Disruption to Studies process, you will have to write a supplementary exam in the supplementary exam period. In this scenario, only your supplementary exam mark will count towards your final exam mark, irrespective of whether or not you attended the final exam in the normal examination period. The submission of a Disruption to Studies form should not be used as a ‘just in case’ strategy.

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.

Grade and Attendance Requirements

Attendance Requirements   

You are to attend the tutorial in which you are enrolled. Permission to attend an alternative tutorial requires permission from the unit convener.  Attendance is mandated at a minimum of 80% attendance.  Failing to meet this minimum attendance will have a negative impact on your grade. You must attend at your allocated time and clinic in order to meet a minimum of 90% attendance at your junior clinic internship shift.

 

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.

 

Passprovides 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.

A passing mark for the final OSCE is required.

 

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.

Outlined below are the necessary requirements for each grade level.

GRADE

REQUIREMENT

Pass

Meeting the Hurdle requirements

Credit

Meeting the Hurdle requirements; PLUS a minimum 70% total raw mark

Distinction

Meeting the Hurdle requirements; PLUS a minimum 80% total raw mark

High Distinction

Meeting the Hurdle requirements; PLUS a minimum 85% total raw mark

Hurdle Requirements and Serious Attempt Defined

There are 4 Hurdles required to pass this unit

Hurdle 1) Rehab Practical Component (comprised of 2 practical examinations): must obtain 60% of combined available marks

Hurdle 2) Rehab Theory Component (comprised of rehab plan, group presentation, and rehab theory exam): must obtain 60% of combined available marks.

Hurdle 3) Clinic Prep Theory exam: must obtain 60% of available marks

Hurdle 4) Must pass the Clinic Prep OSCE: a pass/fail assessment

Serious Attempt: A serious attempt is defined as earning within 10% of the assessment hurdle

Second Chance: A supplementary practical exam will be offered for the Rehab practical component. A supplementary Rehab theory exam will be offered for the Rehab theory component. A supplementary Clinic prep theory exam will be offered for the related theory exam. A VIVA format exam will be offered for the OSCE.

Changes since First Published

Date Description
27/07/2016 I have added the disruption of study policy