The MDNEW8000 curriculum incorporates the theoretical and clinical applied knowledge, skills, and professional behaviours required for you to attain, so that by the end of Year 4 you are able to function independently as a doctor. The Graduate Outcomes of the course are the Graduate Outcome Statements of the Australian Medical Council (AMC). The streams that serve as a scaffold for learning across the 4 years, also become the integrative component between the yearly Unit Learning Outcomes and the Graduate Outcomes across the program.
Year 3 involves you usually continuing at the same primary care practice; the three days/week now provide you with regular ongoing opportunities to embed and apply the foundational knowledge gained in the first two years. The initial focus will be on enhancing clinical and communication skills with patients, ensuring that you can conduct a comprehensive patient-centred history, physical and mental status examination, and further developing your clinical reasoning skills. Being part of the primary team will allow you to experience how patients are placed at the centre of their care and provide the context to further develop your patient-centred consultation skills.
On your journey to becoming culturally safe, you will have opportunities for deep exploration by being exposed to different cultures, patient diversity and role models within the local community. As you participate in providing supervised care across the year to patients and their families, observing the patient's journey from diagnosis to treatment and recovery, you will gain an appreciation of the value of continuity in the healthcare process. Being in the community setting will provide exposure to a broad range of clinical presentations, how undifferentiated disease presents and a range of experiences highlighting how the multi-disciplinary team works in providing comprehensive care. There will be an emphasis on the management of long-term conditions and the importance of partnership with patients, their families, carers and the community for holistic and culturally appropriate care delivery.
Learning will be enhanced by being placed in a community of learning with most practices having a variety of other health discipline learners, prevocational trainees, and general practice registrars. Extended, ongoing interactions will allow you to build stronger relationships with patients, supervisors, mentors, and within interprofessional healthcare teams. This will assist you in the development of your critical reflective, communication and leadership skills.
The Unit Learning Outcomes will be achieved through your active participation in all aspects of the care provided to patients and their families. Highly trained General Practitioner (GP) Supervisors will support and guide you in your learning, closely monitor your progress, and offer regular feedback within a coaching model. There will be opportunities to interact with other GPs in the practice, as well as other health providers and social services in the community and be involved in community health outreach services.
Primary Care (3 days) As a Year 3 student, you will spend three days a week in a general practice clinic, allowing for full involvement in the clinical team. Each week, you will encounter patients with conditions spanning the major medical disciplines of General Practice, Internal Medicine, Surgery, Women's Health, Children's Health, and Mental Health. This year features a carefully designed symposia framework that addresses common and significant presentations in general practice. Initial symposia will provide an overview of the principles and content for the year across the main disciplines. Subsequently, topics will primarily follow a symptom-based approach, integrating contributions from all disciplines, as patients in general practice often present with multi-faceted concerns. These symposia promote a generalist approach, encouraging a broad, whole-patient perspective in primary care. This symposium framework, along with associated asynchronous learning materials, will establish a strong foundational understanding across all of medicine, preparing you well for Year 4 hospital-based practice. Both the symposia and your GP supervisor will guide you in acquiring the necessary clinical knowledge and skills to manage these conditions. You will learn what can be managed within a primary care setting and how to identify when conditions require referral to secondary or tertiary healthcare services. This prepares you to further your learning in these areas during Year 4 in hospital settings. You are encouraged to link all the learning you do to the patients seen in the clinic as well as attending the faculty facilitated learning for the week. As all the resources for these Disciplines will be available from the start of the year, you can access them at any time and work at your own pace using the patient interactions you have encountered to cover the curriculum. If it becomes evident to you or your GP Supervisor that there are gaps in what you are experiencing, your supervisor will raise this in their quarterly report. The medical school placements team will then do their best to arrange opportunities for you to fill those gaps in (e.g. through a short-term placement in a clinic that sees a lot of what you are missing out on). You will also be invited to regularly give feedback on your placement experience. You will learn by undertaking more complete and complex activities of clinical work supervised by the wider team. The following activities may be undertaken by you with appropriate informed consent of the patient and under appropriate supervision: Every day and on multiple occasions: - Taking an appropriate history from the patient, and talking to family or support people if present;
- Undertaking a physical examination of the patient;
- Proposing a management plan and presenting this to the general practitioner;
- Discussing the management plan with the patient and family/carers/support people if appropriate;
- Being part of patient triage and practice meetings;
- Undertaking closely supervised procedures
In most weeks: - Undertaking consultations in the isolation area or urgent care part of the practice, if available;
- Undertaking simple procedures e.g. testing urine, ECG, PEFR, spirometry, reviewing wounds, removing sutures;
- Providing education to patients and families on common conditions, e.g. asthma, diabetes, gout.
In some weeks: - Participating in after hours consultations with the clinical supervisor;
- Following (“shadowing”) the patient to allied health services e.g. pharmacy, optometry, physiotherapy, speech therapy.
If possible: - Visiting a residential aged care facility with the GP;
- Conducting a home visit with one of the primary care team members;
- Attending an antenatal clinic and/or home visits with a midwife as appropriate;
- Being in a community health service e.g. drug and alcohol, well child health, mental health, youth hub;
- Following a patient into the labour suite;
- Following a patient into the hospital.
Every interaction with patients and families will raise questions that you are encouraged to read around and discuss with your GP Supervisor, other GPs in the practice and other appropriate clinicians e.g. senior nurse practitioner, pharmacist, midwife. These activities to follow are a guide, as you will be self-directed, actively reflecting and planning your next learning steps. Your GP Supervisor will help guide you in identifying your learning needs, accessing resources and offering feedback. Primary Care Learning Activities When observing, or interacting with a patient you may identify a main Discipline in their presentation. This is the opportunity to access the guidance around the key learning that is required to be attained in that Discipline area. This is documented in the Discipline outlines and includes consultation skills, physical examination and procedural skills. Each time you encounter a presentation we encourage you to think about whether there is any assessment that can be linked to this encounter for your learning and evidence in your portfolio. Examples would be artefacts for your portfolio and any opportunities that allowed you to undertake a more formal assessment, e.g. a MiniCEX, DOPS or an EPA.
MD Project (1 day) One day a week (or equivalent) will be set aside for you to work on your MD Project. In selected research project situations, you may choose to do a dedicated 8-week research project away from home and your primary care placement. This will require discussion with your GP Supervisor, Year Coordinator and Research Supervisor. The clinical schedule will be suitably adjusted to make up the missed (24) clinical days.
Faculty Learning Activities (half day) There are three faculty-led learning activities each week, comprising in total one half-day. Each week is based around a theme to help you integrate your learning, access these different learning activities and draw from what you experience in clinical practice.
Symposium The staff member will also guide you on how best to access and use all the available asynchronous resources. These will be available from the start of the year for you to access at any point in your learning journey. Following this the topics are predominantly based around a symptom approach in which all the Disciplines will contribute, as patients in general practice do not usually attend with a concern in only one Discipline. These symposia will encourage you to take a generalist approach and explore broadly the whole patient approach to patient care in primary care. This carefully constructed curriculum will cover the common and important presentations seen in general practice. This will provide you with a solid base of understanding across all of medicine and will prepare you well for your Year 4 hospital-based clinical experiences. These symposia will be delivered by faculty staff, specialist general practitioners, and other experts.
Facilitator Case-based Discussions Each week there will be interaction with faculty through 1-hour facilitated student-led case-based discussions (CBDs) which will aim to explore in depth whole person care and generalist approaches and highlight issues in the streams of Artificial Intelligence and Digital Health, Advocacy and Public Health, First Nations Health, Cultural Safety and Equity, Research and Evidence-based Medicine and Quality and Safety. These CBDs will also contribute to the assessment of your progress. During the year, you will, in turn, in these small groups take the lead as presenter and discussant.
Emerging Practitioner Learning Groups Each week the EPLGs will continue to provide ongoing experiential learning to enhance and embed your learning in the Leadership and Professionalism Stream. The activities continue to be structured under the six themes (leadership and teamwork; professional skills; critical reflective practice; ethics, standards, and the law; doctor as educator and coach; and doctor’s health and well-being) and provide a safe sense-making group now you are immersed in clinical practice. In the later part of the year you and your peers will lead the reflective groups, which will enhance your small group facilitation, leadership, and reflective skills. You will be expected to demonstrate leadership skills within the community by undertaking an interdisciplinary project, the Primary Care Leadership Project. This project involves you identifying a First Nations people’s health or equity issue that needs addressing, and working with members of your local health community to address the issue through a creative educational or other intervention. It is expected that you will continue to provide evidence in your portfolio to demonstrate your learning achievements and progress towards achieving the outcomes of the program. A focus is on reflecting on your skill development with real interactions with patients and their families and applying your clinical knowledge. 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.
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: - Targeted advancement required
- MUST address feedback
- Opportunity to address feedback
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