Transition to Practice

This subject has the following teaching availabilities in 2015:

40 hours per week for 15 weeks

For the purposes of considering request for Reasonable Adjustments under the Disability Standards for Education (Cwth 2005), and Student Support and Engagement Policy, academic requirements for this subject are articulated in the Subject Overview, Learning Outcomes, Assessment and Generic Skills sections of this entry.

It is University policy to take all reasonable steps to minimise the impact of disability upon academic study, and reasonable adjustments will be made to enhance a student's participation in the University's programs. Students who feel their disability may impact on meeting the requirements of this subject are encouraged to discuss this matter with a Faculty Student Adviser and Student Equity and Disability Support: http://services.unimelb.edu.au/disability

This capstone subject draws together students’ learning in the context of contemporary health care delivery and prepares the student for the next phases of medical training (prevocational and vocational). This will be achieved in three 5 week terms:

1. Preparation for Practice connects students’ prior learning throughout the MD program to the delivery of safe and effective practice. This will be achieved with a variety of approaches including simulation, group discussion and practical sessions. Students will take this term in the first four weeks, and the final week of the semester.

Students will then rotate through two five week terms:

2. Trainee Intern provides the student with an opportunity to rehearse the role of an intern in a hospital-based medical or surgical unit. Students will be supported to reflect on their experiences within this term to allow a smooth and less stressful transition to internship.

3. Vocational Selective allows students to select a specific medical discipline for more in-depth experience working with an individual clinician or medical team. Students will complete a project (audit, case review or similar) within this term to facilitate active participation in the clinical service.

In line with the graduate attributes of the Doctor of Medicine, by the end of the subject students should have developed the following objectives under these domains:

SELF
• understand the principles of empathy, compassion, honesty, integrity, altruism, resilience and lifelong curiosity, demonstrate them and recognise their importance in health care
• understand the principles of reflective practice, apply them, and recognise their importance in health care
• understand the principles of self-awareness, recognise when clinical problems exceed their knowledge and skill, and be willing to seek help
• identify and address their own learning needs
• respond constructively to appraisal, performance review or assessment
• manage uncertainty
• apply effective time management and organisational skills
• recognise and manage emotion in themselves and others
• maintain their own physical, emotional, social and spiritual health and recognise the importance of professional support in this process
• recognise their own personal, spiritual, cultural or religious beliefs and be aware that these beliefs must not prevent the provision of adequate and appropriate care to the patient.

KNOWLEDGE
• understand the scientific method relevant to biological, behavioural and social science
• understand research methods and their applications
• understand normal structure, function and development of the human body and mind at all stages of life
• understand the molecular, biochemical and cellular mechanisms that are important in maintaining the body’s homeostasis
• understand normal life processes including conception, development, birth, ageing and death
• understand the factors that might disturb normal structure, function and development
• understand the aetiology, pathology, symptoms and signs, natural history and prognosis of important physical and mental illnesses in all stages of life
• understand the management (pharmacological, physical, nutritional, behavioural and psychological) of important medical conditions
• access new knowledge from all sources, analyse and interpret it in a critical manner, and apply it appropriately to their provision of health care
• learn from patients, health professionals and the community in a broad range of settings
• appreciate the responsibility to contribute towards the generation of new knowledge.

PATIENTS
• understand and respect for the rights of patients including patient choice, dignity and privacy
• communicate with patients from diverse backgrounds including listen to, respond to, inform and understand the patient’s perspective
• advocate appropriately on behalf of the patient
• understand factors affecting human relationships and the psychological, cultural and spiritual well-being of patients
• understand principles of rehabilitation in the amelioration of suffering from acute or chronic disability
• understand the principle of the care of the dying and demonstrate a commitment to ease pain and suffering in all patients
• understand chronic illness and disability and its impact on the patient, their carers and communities
• construct with the patient an accurate, thorough, organised, medical history and to perform an accurate physical and mental state examination
• integrate and interpret clinical findings and apply rigorous reasoning to arrive at an appropriate diagnosis or differential diagnosis
• select and interpret the most appropriate and cost effective diagnostic procedures
• formulate an evidence-based and cost effective management plan in collaboration with the patient
• recognise serious illness
• perform relevant medical procedures effectively and safely, with due regard for the patient’s comfort including important emergency and life-saving procedures
• recognise that it is not always in the interests of the patient to do everything that is technically possible to make a precise diagnosis or to attempt to modify the course of an illness.

MEDICAL PROFESSION
• understand the continuum of medical training and the diverse roles and expertise of doctors
• understand the potential conflicts of interest that may confront doctors
• understand and be able to apply the principles of ethics in the provision of health care and research
• understand organisational governance, be an active participant in professional organisations, and appreciate the benefits of this participation
• understand the principles of mentorship and apply them with colleagues
• give effective feedback to colleagues in order to help them improve their performance
• understand educational theory and practice, and teach
• appreciate the responsibility to maintain standards of medical practice at the highest level throughout a professional career.

SYSTEM OF HEALTH CARE
• understand the roles, responsibilities and expertise of all health professionals, and how they work in teams to deliver health care
• demonstrate respect for the roles and expertise of other health care professionals and communicate effectively with them
• understand the principles of team work and work effectively in a team, including as a leader
• appreciate the responsibility to contribute to the education of all health professionals
• understand the principles of efficient and equitable allocation and use of finite resources in health care systems, locally and globally
• understand the principles of quality and safety in health care systems
• work effectively as a doctor within a quality and safety framework including recognising, responding to and learning from adverse events and medical errors
• understand the principles of effective record keeping and maintain high quality medical records
• understand the structure of the Australian health care system and health care systems globally
• understand the role of political systems in shaping health care systems locally, nationally and internationally
• understand the principles of continuity and coordination of health care.

SOCIETY
• understand the interactions between humans and their social and physical environment
• understand the determinants of a well society and the economic, political, psychological, social and cultural factors that contribute to the development and persistence of health and illness
• understand the principles of health promotion including primary and secondary prevention
• understand the health of indigenous Australians including their history, cultural development and the impact of colonisation and the ongoing health disparities of indigenous people in this country and globally
• understand the burden of disease in differing populations and geographic locations
• understand the differing requirements of health care systems in a culturally diverse society
• consider local, regional, national and global ramifications of health care issues
• respect community values, including appreciating a diversity of backgrounds and cultural values
• understand the principles of health literacy and be willing and able to contribute to the health education of the community

• be willing and able to contribute to the community
• Demonstrate a commitment to contributing to the resolution of health inequities locally and globally
• understand the relationship between environmental issues and the health of local communities and society
• demonstrate a commitment to practise medicine in an environmentally responsible way.

Preparation for Practice

• Situational judgement tests, written, 3 x 80 minute, during term, [Pass/Fail]
• Satisfactory performance in simulation exercises, during term, [Pass/Fail]

Vocational Selective

• Safety and Quality Improvement Project Plan, 1000 words (eg. patient safety, infection control, clinical audit), during term, [Pass/Fail]
• Supervisor report (using structured report form), end of term, [Pass/Fail]
• Case Based Discussion, 2 x 30 mins each, during term, [Pass/Fail]

Trainee Intern

• Case Based Discussion, 2 x 30 mins each, during term, [Pass/Fail]
• Multisource feedback (coordinated by supervising intern) using structured feedback form, end of term, [Pass/Fail]

Subject Overall

• Log Book - satisfactory completion of clinical tasks as specified in each rotation
• International Form of the National Board of Medical Examiners (NBME) Step 2 Clinical Knowledge Test, 2 x 2 hr MCQ exam, end of second term, [Pass/Fail]

Hurdle requirements

• Students must reach a satisfactory standard in the IFOM, pass the three Situational Judgement Tests, three of four Case Based Discussions, the Multisource Feedback report and the Supervisor Report in order to pass the subject
• Students must also achieve a satisfactory standard in the Professional Behaviour Checklist; satisfactory standard of designated procedures; 100% attendance at clinical placements and scheduled teaching activities. In cases of time missed due to serious illness or other causes of approved leave of absence, the board of examiners may, at its discretion, require supplementary attendance or a supplementary assessment to enable a student to fulfil the subject requirements
• Satisfactory completion of clinical procedures as specified in each rotation
• If the score on the Clinical Knowledge Test falls below a satisfactory standards, students will be required to sit a further 1 hour MCQ examination during the exam period at the end of the subject.

This subject is not available as a breadth subject.

• A relationship with self that allows professional skills in well organised, reflective and appropriate practice to be complemented by the personal attributes of a compassionate, self aware practitioner.
• A relationship with knowledge that allows comprehensive, evidence-based and contemporary best practice.
• A relationship with patients that allows respectful, mindful, safe and patient-centred practice.
• A relationship with the medical profession that promotes the highest standards of ethical practice and a lifelong commitment to continuing professional development.
• A relationship with systems of health care that uses teamwork and leadership to ensure high quality, safe and efficient practice.
• A relationship with society that allows practice aimed to address issues of health inequity, health illiteracy and disadvantage at a local and global level.