Students

CHIR919 – Clinical Management

2018 – 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 (Rehab)
Curtis Rigney
Contact via curtis.rigney@mq.edu.au
C5C 367
By appointment
Lecturer
Matthew Fernandez
Lecturer
Hazel Jenkins
Rehab Tutor
Lucinda Slavin
N/A
N/A
Lecturer and tutor
Melinda Brookes
Contact via melinda.brookes@mq.edu.au
Rehab Tutor
Kym Abbott
N/A
N/A
Lecturer and tutor
Krystle Tran
Lecturer and tutor
Christopher Jolliffe
Lecturer and tutor
Aret Aboulian
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
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise
  • Further develop skills for critical analysis of research
  • Undertake a junior internship period meeting assessments relating to the operations of the clinic systems
  • Explain the role of outcome measures; describe their use and interpretation
  • Outline an appropriate physical examination and interpret the findings from physical examination
  • Be aware of the potential underlying pathological or dysfunctional condition as related to each examination procedure

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 rehab practical will be posted at the end of the exam period.

2. Assignment: Results will be available from the Turnitin link in Week 13. General feedback will be given during lecture.

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

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

5. OSCE results will be made available on iLearn.

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

7. Students must bring their own devices to assessments conducted in tutorials and junior clinic internship for marks to be entered directly

Assessment Tasks

Name Weighting Hurdle Due
Assignment 10% Yes week 7
Junior Internship 15% No Ongoing
Final Rehab Practical 20% Yes week 12 & 13
Clinical Competency Exam 0% Yes week 13
Rehab Theory Final Exam 20% Yes Exam Period
Clinic Prep Theory Examination 20% Yes Exam Period
4 Clinical Assessments 15% No weeks 12 & 13

Assignment

Due: week 7
Weighting: 10%
This is a hurdle assessment task (see assessment policy for more information on hurdle assessment tasks)

This essay assignment will assess a student’s ability to develop a search strategy and to critically appraise a published randomised controlled trial related to active care intervention for a musculoskeletal condition.


On successful completion you will be able to:
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise
  • Further develop skills for critical analysis of research

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, appropriate 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 during the delivering of treatment. During this internship period, every intern must competently complete the 'Consent Clinical Assessment' task on a new patient, meet competency in taking vitals, complete a competent Urinalysis and completion of an evidence based questionnaire task.

The initial marks awarded at the time of  initial assessment will not be changed, however if a student does not meet competency, then they will be offered a retake in Week 12 or 13. A maximum number of retakes is 2 for any given assessment. The assessment of each system must be demonstrated to be at a level of competency in order to pass this unit.


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
  • Explain the role of outcome measures; describe their use and interpretation

Final Rehab Practical

Due: week 12 & 13
Weighting: 20%
This is a hurdle assessment task (see assessment policy for more information on hurdle assessment tasks)

Comprehensive assessment of rehab skills (assessment and management).


On successful completion you will be able to:
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise

Clinical Competency Exam

Due: week 13
Weighting: 0%
This is a hurdle assessment task (see assessment policy for more information on hurdle assessment tasks)

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
  • Outline an appropriate physical examination and interpret the findings from physical examination
  • Be aware of the potential underlying pathological or dysfunctional condition as related to each examination procedure

Rehab Theory Final Exam

Due: Exam Period
Weighting: 20%
This is a hurdle assessment task (see assessment policy for more information on hurdle assessment tasks)

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
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise

Clinic Prep Theory Examination

Due: Exam Period
Weighting: 20%
This is a hurdle assessment task (see assessment policy for more information on hurdle assessment tasks)

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

4 Clinical Assessments

Due: weeks 12 & 13
Weighting: 15%

Assessment of students will be taken in weeks 12 &13 during the tutorial times. The assessments will be as follows:

Week 12 Cardiovascular and respiratory

Week 13 Gastrointestinal and vitals

 


On successful completion you will be able to:
  • Outline an appropriate physical examination and interpret the findings from physical examination
  • Be aware of the potential underlying pathological or dysfunctional condition as related to each examination procedure

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 which will also be conducted 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 T2 (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 attendance changes permitted after week 2

Required and recommended resources

  • Required texts:

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

  • Recommended texts:

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

- 2018 Department of Chiropractic Clinic Manual

- Kendall. Muscle testing and function with posture and pain 5th ed. LWW

Unit Schedule

CHIR119 Clinical Management 2019 Rehab schedule (Subject to change)

Week

Tutorial

Lecture

1

30/7-3/8

Muscle Length and Strength Assessment

Strength & Fitness

CTR

2

6-10/8

Theraband

Sensory Motor Stimulation

CTR

3

13-17/8

SMS Small Foot

Muscle Weakness

CTR

4

21-24/8

SMS

Rehab Management

CTR

5

27-31/8

SMS

Spinal Stabilisation

CTR

6

3-7/9

Functional Neutral Postures

Total Gym

Spinal Loading

CTR

7

10-14/9

 

Cervical/Thoracic Rehabilitation

HJ

8

2-5/10

No Tutorial

Labour Day

Exercise Science

MF

9

8-12/10

Exercise Therapy

 

Active care foot, knee, and hip

10

15-19/10

Exercise Therapy

Active care hand, elbow, and shoulder

11

22-26/10

Exercise Therapy

Active care low back, no tech, low tech, high tech

12

29/10-2/11

Final Practical

Active care cervical and headache

13

5-9/11

Final Practical

Revision

 

Clinic Management Lecture schedule

Week

Week Commencing

Topic

1

30/07/18

Introduction to unit, role of CBA, student responsibilities

2

06/08/2018

Introduction to clinic paperwork

3

13/08/2018

Professional letter writing

4

20/08/2018

Co-morbidities

5

27/08/2018

Mental health

6

03/09/2018

The pregnant patient

7

10/09/2018

Paediatrics

Mid Semester break

 

 

8

01/10/2018

Practical paediatric and pregnancy

9

08/10/2018

Geriatrics

10

15/10/2018

How to deal with a difficult patient

11

22/10/2018

Post-surgical patient

12

29/10/2018

No lecture

13

05/11/2018

No lecture

Policies and Procedures

Macquarie University policies and procedures are accessible from Policy Central (https://staff.mq.edu.au/work/strategy-planning-and-governance/university-policies-and-procedures/policy-central). Students should be aware of the following policies in particular with regard to Learning and Teaching:

Undergraduate students seeking more policy resources can visit the Student Policy Gateway (https://students.mq.edu.au/support/study/student-policy-gateway). It is your one-stop-shop for the key policies you need to know about throughout your undergraduate student journey.

If you would like to see all the policies relevant to Learning and Teaching visit Policy Central (https://staff.mq.edu.au/work/strategy-planning-and-governance/university-policies-and-procedures/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/study/getting-started/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
  • Further develop skills for critical analysis of research
  • Undertake a junior internship period meeting assessments relating to the operations of the clinic systems
  • Explain the role of outcome measures; describe their use and interpretation
  • Outline an appropriate physical examination and interpret the findings from physical examination
  • Be aware of the potential underlying pathological or dysfunctional condition as related to each examination procedure

Assessment tasks

  • Assignment
  • Junior Internship
  • Final Rehab Practical
  • Clinical Competency Exam
  • Rehab Theory Final Exam
  • Clinic Prep Theory Examination
  • 4 Clinical Assessments

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
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise
  • Further develop skills for critical analysis of research
  • Undertake a junior internship period meeting assessments relating to the operations of the clinic systems
  • Explain the role of outcome measures; describe their use and interpretation
  • Outline an appropriate physical examination and interpret the findings from physical examination
  • Be aware of the potential underlying pathological or dysfunctional condition as related to each examination procedure

Assessment tasks

  • Assignment
  • Junior Internship
  • Final Rehab Practical
  • Clinical Competency Exam
  • Rehab Theory Final Exam
  • Clinic Prep Theory Examination
  • 4 Clinical Assessments

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
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise
  • Further develop skills for critical analysis of research
  • Undertake a junior internship period meeting assessments relating to the operations of the clinic systems
  • Explain the role of outcome measures; describe their use and interpretation
  • Outline an appropriate physical examination and interpret the findings from physical examination
  • Be aware of the potential underlying pathological or dysfunctional condition as related to each examination procedure

Assessment tasks

  • Assignment
  • Junior Internship
  • Final Rehab Practical
  • Clinical Competency Exam
  • Rehab Theory Final Exam
  • Clinic Prep Theory Examination
  • 4 Clinical Assessments

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
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise
  • Further develop skills for critical analysis of research
  • Undertake a junior internship period meeting assessments relating to the operations of the clinic systems

Assessment tasks

  • Assignment
  • Junior Internship
  • Final Rehab Practical
  • 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
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise
  • Further develop skills for critical analysis of research
  • Undertake a junior internship period meeting assessments relating to the operations of the clinic systems
  • Explain the role of outcome measures; describe their use and interpretation
  • Outline an appropriate physical examination and interpret the findings from physical examination

Assessment tasks

  • Assignment
  • Junior Internship
  • Final Rehab Practical
  • Clinical Competency Exam
  • 4 Clinical Assessments

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
  • Describe the rationale for and perform afferent therapies, core stabilization, spinal loading, and progressive exercise
  • Further develop skills for critical analysis of research
  • Undertake a junior internship period meeting assessments relating to the operations of the clinic systems

Assessment tasks

  • Assignment
  • Junior Internship
  • Final Rehab Practical
  • 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 practical examination): must obtain 60% of available marks

Hurdle 2) Rehab Theory Component (comprised of essay assignment and rehab theory exam): must obtain 60% of combined available marks.

Hurdle 3) Clinic Prep Theory exam: must obtain 50% of available marks.

Hurdle 4) Must pass the Clinic Prep Competency: a pass/fail assessment. A student is given a maximum of 3 attempts to pass this hurdle assessment

Serious Attempt: For Hurdles 1 & 2; a serious attempt is defined as earning within 10% of the assessment hurdle. For Hurdle 3; a serious attempt is defined as earning within 5% of the hurdle assessment. For Hurdle 4; a student is allow up to 3 attempts to pass the hurdle assessment.

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. Up to two additional attempts for the clinical competency examination.

Changes since First Published

Date Description
31/07/2018 A mistake in assessment timing has been corrected. The clinical assessments are to take place in weeks 12 and 13. Sorry for the inconvenience