Development of Clinical Practice

MDNEW7000 Development of Clinical Practice is the second year of the 4-year graduate Doctor of Medicine (MD) Çourse and follows the Year 1 MDNEW6000 Foundations of Clinical Practice. This year-long Unit of 42 weeks duration (including breaks) is designed to build upon the foundational knowledge acquired in the first year and focus on the further development of essential clinical and patient care skills, and professional behaviours essential for medical practice.

MDNEW7000 employs a blended learning approach, combining small group tutorials, early clinical immersion in the general practice (GP) placement, face-to-face and synchronous online experiences, to foster active engagement, critical thinking and collaboration amongst students. Through the clinical placement in primary care, you have the opportunity to integrate theory with practice, engage with real patients, healthcare professionals and experience the realities of a clinical practice.

Incorporating innovative teaching methodologies and technology, the Unit enhances your student experience and supports your self-directed learning, reflection and professional development. MDNEW7000 is structured to integrate knowledge and skills across various medical disciplines and healthcare contexts including through the Streams integration of Communication and Clinical Skills, First Nations Health, Leadership and Professionalism, Research and Evidence-Based Medicine, Advocacy and Public Health, Cultural Safety and Equity, Artificial Intelligence and Digital Health, and Quality and Safety with Applied Clinical Knowledge. 

The MDNEW7000 curriculum incorporates the theoretical knowledge, necessary skills, professional behaviours and the application thereof, required for a doctor in training, so that you are able to function independently as proficient medical doctors in the Australian medical system upon graduation. The Graduate Outcomes of the MD program are the Graduate Outcome Statements of the Australian Medical Council (AMC). The streams serve as a scaffold for learning across the 4 years, which then also become the integrative component between the yearly Unit Learning Outcomes and the Graduate Outcomes across the course.

The MD course is committed to preparing future healthcare professionals utilising a programmatic assessment system that aligns with its MD course design, ensuring a holistic view of student progress over four years. This system is consistent with principles of fairness, flexibility, equity, validity, and reliability, supported by medical education research and evaluation.

MDNEW7000 is structured into five body system-based modules allowing you to integrate knowledge and skills across the medical and clinical sciences with the program-wide Streams of Communication and Clinical Skills, First Nations Health, Leadership and Professionalism, Research and Evidence-Based Medicine, Advocacy and Public Health, Cultural Safety and Equity, Artificial Intelligence and Digital Health, and Quality and Safety. It continues the exploration of the structure, function, development and pathologies of the human body associated with these systems, as well as providing opportunities for integration of this learning into the whole-person approach to medical knowledge and care with the body systems covered in Year 2. 

Back-to-Base (B2B)

To support your learning during the modules, three Back to Back (B2B) intensive weeks are scheduled across the year. These intentionally incorporate learning tasks that are best carried out in a ‘face to face’ group setting, such as practising clinical and communication skills, team-building and group work. These intensives also act to reinforce content covered during the year, allowing the B2B to function as both a vertical and horizontal integrative aspect between coursework and clinical placement throughout the program.

The learning experiences in Year 2 are a continuation of those offered in Year 1 and offer mixed teaching methods in the form of face to face, online synchronous and self-directed learning. Experiential learning and coaching in early clinical skills remain a considerable focus in these weeks, providing the opportunity for iterative practice of history gathering, system- and region-based examinations, more complex consultation and procedural skills, that can then be further developed in general practice placement.

First Nations Health

The health of First Nations peoples is addressed specifically through the First Nations Health curriculum (refer to Accreditation Document for First Nations Medical Program) as well as integrated throughout the program. The detailed outcomes and key themes for this learning are listed below: 

Key Themes

• Racial Literacy and First Nation Health
• Examines race and racism in healthcare, promoting anti-racism praxis. This theme is essential for developing the skills to identify and challenge racism within healthcare systems.
• First Nations Health and Communication
• Focuses on verbal and non-verbal communication, strengths-based approaches, and community partnerships. Effective communication is a cornerstone of patient-centred care, especially in diverse cultural contexts.
• Research Principles and First Nation Health
• Explores culturally appropriate research and ethical practices in working with communities. Ethical research practices are vital for conducting studies that benefit First Nations communities and respect their rights and autonomy.

Case-Based Learning (CBL)

An essential component of MDNEW7000 is the Case-Based Learning (CBL). During CBL, you will acquire knowledge and skills in the context of integrated clinical cases discussed in a small learning group setting. Working in groups of no more than 10, you will engage with case scenarios with Streams woven in. These small groups will apply their knowledge of basic sciences, develop clinical reasoning, critical thinking, and problem-solving abilities to diagnose, treat, and manage the presented scenarios. The cases are structured to expose you to a variety of presentations and contexts pertinent to Year 2 modules, but also building up from Year 1 curriculum. CBL also promotes collaboration and acts to integrate the supportive medical sciences and student clinical experience. You are evaluated on your CBL contribution across multiple Streams and receive feedback from your tutors.

Emerging Practitioner Learning Group (EPLG)

Another key activity scheduled weekly across the year is the EPLG, designed to continue and expand your learning in the Leadership and Professionalism Stream. Further skill development occurs in the theme of leadership and teamwork, professional skills, critical reflective practice as well as deeper exploration of cultural, ethical and legal issues, peer teaching, coaching and wellbeing. There will be opportunities to share and discuss your reflections and progress with your EPLG facilitator as well as your portfolio mentor during the two structured portfolio reviews.

Clinical Workshops

Clinical workshops are dynamic, small-group, facilitator-led sessions designed to build on your foundational communication and clinical skills. Using clinical scenarios aligned with the Year 2 modules, these workshops provide a practical environment to refine your ability to conduct person-centred medical histories, gain familiarity with both system-focused and symptom-focused physical examinations, including sign interpretation, and extend your clinical reasoning by applying it to investigations and management strategies. Dedicated communication skills sessions will guide you through increasingly challenging and complex patient interactions. Further opportunities to practice and consolidate your clinical skills will occur in your weekly placements and the B2B weeks, benefiting from direct observation and valuable feedback.

General Practice (GP) Placement

Expanding on your experience in Year 1, you are placed in a GP practice environment, now for one full day a week (or two half-day sessions) so that you have more time in the clinical work environment and can further develop clinical skills. You will be supervised and guided by experienced GPs, practice staff and healthcare professionals engaging in patient care, consultations, health assessments and management of common medical conditions. The lead GP supervisor will closely monitor your learning and offer regular feedback with some coaching.  

During Year 2, in the placement, you will have the opportunity to further your supervised use of learned clinical skills through Early Clinical Tasks (ECTs), mini-Clinical Evaluation Exercises (mini-CEXs) and Direct Observation of Procedural Skills (DOPS). Teaching and learning these skills progresses and aligns with the body system modules: the opportunities to practise/perform these skills will come in the placement sessions.

As a learner you are expected to move towards increasingly being able to think, behave and understand clinical care as a doctor does. Over this year you will learn to participate in a critically reflective way. By reflecting on experiences, and receiving and processing feedback from multiple sources, you will move towards being a member of the healthcare team in a way that starts to contribute to patient care. When your GP believes you are ready, they will invite you to perform clinical examinations, suggest diagnoses, and focus on holistic, patient-centred approaches. By the end of the year, to enable you to transition into year three, you will need to demonstrate that you are able to collaborate with the team, engage in clinical discussions and decisions, and apply situated reasoning.

The lead (nominated) GP supervisor will closely monitor your learning and offer regular feedback with some coaching. Quarterly reports will provide a means to record feedback and progress.

In addition, your own insights relating to your placement experience will be sought on a regular basis, and you will also be given opportunities to provide feedback (confidential or otherwise, should you choose).

Context(s) of Practice (ConPrac)

 In the Context of Practice masterclasses, the medium sized learning group provides scaffolding in which broader contexts of medicine are embedded and explored, such as the roles and responsibilities of medical doctors within societal and healthcare settings. The Streams will become more explicit in these masterclasses: First Nations Health, Advocacy and Public Health, Artificial Intelligence and Digital Health, Cultural Safety and Equity, Research and Evidence-Based Medicine, Quality and Safety, Whole person care and Radiology. Within these masterclasses, students will be guided on the development of the research components associated with the MD Project - the Research Proposal, followed by the Literature Review. Additional self-guided learning time is allocated for the completion of these assessment tasks.

Foundations in Biomedical and Clinical Sciences (BMCS)

The Foundations in BMCS is a 2-hour workshop designed to help you apply the information you acquire from the learning resources you encounter during your private study. Each week this medium-sized learning group (up to 30 students) will focus on core BMCS topics associated with the given module, and provide an online space for you to work through and engage in interactive activities and questions in a learning group.

Question and Answer (Q&A)

This Q&A session is in the form of a 'Lectorial', and serves as an open forum session to consolidate learning. This one-hour facilitated learning activity is a whole-cohort semi-didactic forum that will first summarise the main concepts covered during the week, after which students will then be able to ask any questions relating to the topics covered.

Plenary

Each week, a plenary session in the form of a webinar is scheduled, in which guest speakers will be regularly invited to present on topics covered not only in the biomedical and clinical sciences, but also in the Streams. This whole-cohort webinar is intended to expose students to a vast range of perspectives from different professions, such as health professionals, public health experts, researchers, First Nations peoples, digital experts in health and more, of whom all play an important role in contributing to the advancement of medicine and medical education.     

Programmatic Assessment

The key principles underpinning the assessment framework include its programmatic nature, proportionality, focus on feedback dialogue, focus on growth and continuous monitoring of progress towards defined learning outcomes. This longitudinal approach integrates various assessment methods over time to provide a nuanced understanding of learner progress and competence, spanning "Knows," "Knows How," "Shows How," "Does," and "Is" (revised Miller pyramid).

Central to this programmatic philosophy is the longitudinal and integrative perspective: rather than relying on isolated single-event data points of assessments, programmatic assessment emphasises the importance of longitudinal ongoing evaluation and meaningful integration of assessment information. Information from individual assessments is integrated, allowing for holistic judgements to be formed through triangulation of evidence from multiple sources. High-stakes progression decisions are underpinned by rich data, ensuring transparent, credible, accountable and fair judgments. This program of assessment is grounded in evidence-based practice and promotes learning rather than simply measuring performance.

Assessment for learning is designed to help students recognise and develop strengths in areas of knowledge and skills that require improvement. It aims to provide ongoing feedback and support throughout the learning journey, and it is hence a foundational element of programmatic assessment for learning. Assessment of learning (AoL) is used to demonstrate ‘readiness to progress’ and supports decisions about progression to the next stage of education. Through Assessment as learning (AaL), students are active participants in the assessment process and their progress, with reflection, self-assessment and agency, guided by the Portfolio. While the emphasis is heavily on learning and development (AfL and AaL), programmatic assessment also fulfills the need for AoL, for progress and completion of the program. To support this each assessment outcome is feedback rich and rubrics are designed to report progress against the defined criteria in three categories are:

1. Targeted advancement required
2. MUST address feedback
3. Opportunity to address feedback