Surgery Rotation. Clinician Guide YEAR 4

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1 Bond University Medical Program Surgery Rotation Clinician Guide YEAR 4 Updated 19/12/18

2 Bond University Medical Program Page 2 of 6

3 Surgery Rotation The aim of the Surgical Rotation is to gain practical experience in the initial evaluation, investigation and management of acute and elective illnesses common to General Surgery patients. It aims to train medical students in the basics of general surgical principles, learning how to solve surgical problems as they add on to their basic knowledge, develop clinical judgment and perform motor skills through guided and supervised patient care. Goals The goals for the surgery rotation are: To provide students with learning experiences associated with the clinical care of surgical patients For students to hone their history taking and examination skills and use clinical reasoning to form diagnoses and differential diagnoses For students to learn about and to become comfortable discussing clinical management of patients For students to develop clinical knowledge and understanding of the common conditions in surgery and the principles of surgical management To provide students with a real-life clinical working environment and opportunity to work with a clinical team. Timetable and Contacts Students are expected to be present on a daily basis during their rotation. If students are unable to attend for any reason, they are required to advise the clinician, hospital co-ordinator (where available) and the Placements Team at Bond University. Expected experiences for Surgery Clinical Rotation in Surgery should involve the student actively involved in the day-to-day clinical activities of the clinical unit to which they are attached. It is expected that students will actively be involved in ward rounds, patient case history and examination presentations to the Unit, and shadow the Consultant/Registrar in the performance of their daily routine. This includes after-hours patient care. Unit Ward Rounds Surgical Out-Patient Clinics Specialist Clinics Operating Theatre Sessions Rostered after-hours on call Bond University Medical Program Page 3 of 6

4 Core Topics and Learning Outcomes Student involvement in the day-to-day care and management of patients provides the best opportunity for learning. Students can acquire a great deal of knowledge through interviewing and examining patients and being involved in clinical decision making at the bed side. As well as being assessed on clinical knowledge, students will also be required to display other professional skills during their clinical placement. Ability to work with peers and the multidisciplinary team, ability to consider the psychological and social impact of the illness on the patient and the family, ability to show empathy and honesty and to offer choices and respect the patient s decision, and also recognise their own limitations and stage of training. Peri -Operative Preoperative Assessment Consent Anaesthetic Assessment Thromboembolic Prophylaxis Medication History Pre-operative Procedures Recovery Procedures Postoperative Wound Care Handover Head And Neck Thyroid Disease Neck Masses Chest Breast Lump Breast Abscess Breast Cancer Pneumothorax Lung cancer Abdomen Acute Abdomen Obstructive Jaundice Gastric cancer Hernias Gallstones Bowel Obstruction Ischemic Bowel Colorectal cancer Diverticular disease Pancreatitis Inflammatory Bowel Disease Anal/Rectal Diseases Genitourinary Scrotal Swellings Renal Stones and Masses Acute Urinary Retention Prostatic Disease Testicular Disease Vascular Surgery Abdominal Aortic Aneurysm Limb Ischemia Varicose veins Surgical Oncology Screening for malignancy Staging of cancer Melanoma Bond University Medical Program Page 4 of 6

5 Surgical Infection Soft tissue infections Peritoneal sepsis Procedural Skills in Surgery Urinalysis ECG Venepuncture IV Cannula IV fluid and electrolyte therapy Blood sugar Blood culture Wound swab Nebuliser/inhaler Oxygen therapy Measurement Diagnostic Cardiopulmonary Performing dipstick urinalysis testing Perform and interpret an ECG Performing venepuncture Insertion of an IV cannula Explain fluid and electrolyte balance, how to calculate and the correction of imbalance Estimate the blood sugar using a glucometer Take blood for culture Take a swab from a wound Instruct a patient on using a nebuliser/inhaler Demonstrate the use of oxygen by mask and nasal prongs 12 lead ECG Perform and interpret a normal & common conditions on a 12 lead ECG Peak flow measurement Perform and interpret a peak flow measurement Spirometry Perform and interpret a spirometry reading Arterial blood gas sampling Observe and describe indications for taking an arterial blood gas sampling Pleural effusion/pneumothorax aspiration Observe and describe the indications and principles for inserting a chest drain Proctoscopy Gastrointestinal Observe and describe indications for performing proctoscopy Bond University Medical Program Page 5 of 6

6 Clinical Supervision and Assessment Regular formal education sessions conducted throughout the clinical rotation, will deliver to all students a standardised component of the curriculum. The timing and location for these mandatory sessions will be posted on the website. These formal educational sessions should be organ specific disease based and students should go prepared with relevant questions. These cases should be used to assist students: interpret clinical data discuss possible diagnoses discus principles of clinical management discuss medico-legal, ethical, psychosocial aspects of the case During the clinical placement, students will be supervised and ultimately assessed by a Consultant and often with the Registrar from the allocated team. This assessment will occur during and on conclusion of the rotation. The assessment will involve: 1. Supervising and assessing students regarding their clinical history taking and clinical examination skills. Students should be assessed formally on their examination technique on at least two occasions during their rotation. Students should ensure / request this of the supervising clinician. 2. Monitor students performance and professional conduct during clinical rotations will be collected in Osler eportfolio. Workplace based assessment requirements per rotation include: 2 x ITA (Week 4 formative/week 8 summative) 2 x Clerked Cases (Week 4 formative /Week 8 summative) 2 x Mini-CEX minimum (Student-patient interactions throughout rotation) 1 x Procedural Skill (By Week 6 of the rotation) Any concerns regarding any aspect of student behaviour and/or performance should be immediately relayed to the Medical Program Phase 2 Lead. Clinicians Assessment Committee meetings take place at the end of each rotation to discuss the clinical rotations and student performance. The decision of progression of the student will take place at this meeting taking into consideration all their assessment outcomes. All competency assessment is completed on Bond University s Osler eportfolio App/website. The student requests the supervisor to review their assessment via Osler. The supervisor can be a user of Osler (require login details) or be requested as a Guest Assessor ( link to assessment). It is recommended to be set up as a user if completing numerous assessments. Please contact osler@bond.edu.au for further information or to be set up as a user on Osler. Bond University Medical Program Page 6 of 6