Part A

Over the term, we will have 6 complex cases to work our way through as a group. The initial case information will be released on Monday morning of each week. It is your responsibility to post on the weekly moodle forum, your post should include a differential diagnosis list explaining why each of the conditions is on your list, plan a physical examination explaining why each test you select would be appropriate at some point on Monday, Tuesday or early Wednesday (before noon). On the Wednesday afternoon further information will be released about the case, with this new information you are required to provide on the same forum a most likely working diagnosis with justification, any further investigations you would like and why, plus your management plan. On the Friday of each week, we will either meet for a zoom tutorial or there will be a formative quiz for you to complete in relation to the case.

Part B

As you are about to enter the profession, we will spend some time with the AHPRA Code of Conduct for Chiropractors. In particular we will have two activities, one will involve you finding a piece of advertising material and verbally critiquing it using the AHPRA advertising guidelines. It is expected that you will present your advertising item to the group for a discussion on strong points and weak points of the item. This will be followed by a post to Moodle detailing any breaches of the guidelines.

The second activity will involve you pairing up in groups of four to record an informed consent, a working link to the recording needs to be posted into the Moodle forum.  There is the option to provide an example of a good one or a poor one. As a group, we will critique the presentation using on the Code of Conduct guidelines.

Part C

Multi-discipline Case Conferences - a topical case will be selected for each of the three scheduled case conferences, students will be expected to participate in the discussion with qualified practitioners from a  range of discipline on the complexities of the case and management solutions.

Part A

In order to successfully complete this activity and receive a passing grade, you are required to fully complete 5 of the 6 cases as described above. This includes two forum posts one before Wednesday at noon that details your differential diagnosis list including justifications and a planned physical examination with justifications. This will be followed by a second post after the release of additional case information. The second post must include a working diagnosis with justifications, any further investigations required and an evidence informed plan of management and be completed before the weekly zoom discussion. The final component is participating in the weekly zoom discussion or completing the formative quiz associated with the quiz. It is your responsibility to ensure that your posts are on the weekly forum by the timelines described. Failure to do complete the required components of 5 of the 6 cases will result in a fail grade for this activity. As this unit is graded on a pass/fail basis, failure of an activity will result in a fail grade of the unit.

Part B

In order to successfully complete part B which involves engaging with the Code of Conduct for Chiropractors, you will be required to source an example of chiropractic marketing material (this can be international or local but please remove names and phone numbers). It is then your responsibility to present the item to the group and the group will discuss the strong and weak points of the marketing material. The second activity involves recording an informed consent in groups of four and posting a link to your video on the weekly moodle forum (try to keep these to no longer than 5 minutes), it is your responsibility to ensure that the link works and all members of the group participate. As a group we will critque the videos using the Code of Conduct for Chiropractors guidelines to strengthen our abilities to perform at the level expected by AHPRA and the CBA. Failure to complete the required components will result in a fail grade for this activity. As this unit is graded on a pass/fail basis, failure of any activity will result in a fail grade for the unit.

Part C

In order to successfully complete part C, you will be required to attend a minimum of 2 of the multidisciplinary case conferences.  In addition to attending, you will need to submit via the forum prior to the conference starting one question or comment that you would like addressed by the panel during the conference discussion.

Attendance and clinical requirements

As a health care professional your attendance is relied upon for the provision of quality patient care. Your absence and or tardiness impacts service delivery and safe patient care. It is expected that you attend 100% of the scheduled time during the clinical placement to achieve the required clinical attendance. All hours worked must be entered into the clinical attendance form in your logbook. This e-form must be signed by your clinical supervisor.

The clinical attendance form is available in your logbook.

Public holidays are included as hours worked. You can log your shift hours worked for each public holiday. These do not need to be 'made up'.

Any time you are away from your clinical institution, you MUST supply a verifiable supporting document indicating why you have not attended. Both your clinical supervisor and the unit coordinator MUST be informed by you of any absences from your clinical placement. Any absence for part, or all of, a working day must be made up during the clinical placement.

During your time in clinic, you MUST complete your clinical requirements as detailed in the clinic manual (This term targets are 120 treatments, 15 new patients consultations, 2 systemic examinations, 20 radiology reports 10 radiographic positioning encounters and 3 lab investigations). The logbook MUST be kept UP TO DATE as logbook audits will be performed periodically throughout the term. It is your responsibility to ensure that all of these requirements are completed in order to attain a pass for this assessment

*If the clinical supervisor deems your skills are not progressing well by week 6 remedial support will be offered*

To pass this assessment you must attend all scheduled shifts AND provide documented evidence of completion of the clinical requirements (Both term and final year totals see above for required numbers). Any days away from your clinical site must be documented and approved prior to leave being taken and must be signed by the primary clinical supervisor and reception. In addition, it is your responsibility to make this time up. Any shortfall in clinical requirement numbers or attendance hours must be completed before this task can be awarded a passing grade.

Clinical requirements are an important measure of your progress and skills development, if the targets set for this term are not met, please submit an explanation to the unit coordinator and your supervisor for further discussion. If there are concerns about your skills development or your ability to meet clinical requirements as detailed this may result in you not passing this unit.

Overall Clinical Performance and Competency Assessments

Clinical placement occurs in a professional workplace. As a clinical student you are provided access to that workplace on the condition that you demonstrate behaviours and attributes of a healthcare professional and present a positive image to the staff and clients. As a student in the chiropractic profession in Australia, you are required to be in consistent compliance with the AHPRA Code of Conduct for Chiropractors (AHPRA Code of Conduct for Chiropractors).

This assessment considers your ability to communicate professionally with a diverse cultural audience of patients, staff and the general public, demonstrate professional respect for all, and function as a reliable, competent, well organised member of the health team.

It is your responsibility to ensure that the following competencies are completed by the end of week 10:

• 2 history taking scenarios
• 1 physical (ortho/neuro) examination
• 1 systemic examination
• 3 adjustive techniques (at least one extremity)
• 1 report of findings
• 1 rehabilitation functional screen
• 1 file audit
• 2 Overall clinical competence assessments (OCCA) (one formative during week 6 and one summative which will be completed during week 11)

Your clinical supervisor, or delegate, will be working with you, directly observing your day-to-day performance, and/or obtaining feedback from supervising chiropractors who are doing so. These observations and completed competencies relating to your demonstrated knowledge, skills and behaviours over the term, will contribute to the grades awarded in the final Overall Clinical Competence Assessment provided on Moodle.

There are seven main sections to the OCCA form:

· Section 1: Professional Behaviour

· Section 2: Communication

· Section 3: Patient Assessment

· Section 4: Clinical Reasoning and Planning

· Section 5: Interventions / Management

· Section 6: Evidence-based/Informed Practice

· Section 7: Documentation

In each of the 7 sections there are multiple observable behaviours that you are REQUIRED to demonstrate throughout your placement. It is your responsibility to ensure that these are successfully completed. Your assessor will score your performance based on how frequently and to the extent you demonstrate each of the listed behaviours and your completed competency feedback. Your assessor is also encouraged to provide comments to expand on the scoring feedback. This assessment occurs twice during the placement. The first occurs at the mid-placement point (week 6). The mid-placement OCCA is a formative discussion, meaning its function is to provide you and your unit coordinator with formal documented feedback on your performance, but for the formative assessment there are no minimum required scores contributing to your final grade. You are expected to use that feedback to reflect on your performance, develop an action plan to address any areas of performance that are not yet at the target level for this placement, and use the remaining weeks to achieve those targets. For any behaviour that you score well on at the mid-placement assessment, it is expected that you will continue to meet that level of performance or surpass it for the rest of the placement.

The second OCCA assessment occurs toward the end of the second last week of the placement (week 11). The end-of-placement OCCA assessment is summative, in that its primary use is to evaluate and document your competence and performance relative to the stated competence targets. The minimum required scores are listed in the Assessment Criteria section below. Your final overall grade in this assessment depends on where you stand relative to those performance targets.

The OCCA form and marking criteria is available in the assessment block in the unit Moodle site. A copy has been given to the clinical supervisors. It is your responsibility to read the OCCA form carefully to ensure that you understand the criteria against which your professional and clinical behaviour will be evaluated. Your clinical supervisor will meet with you after completing each assessment to discuss it with you. This is your opportunity to get timely clarification on any score or comment on the assessment. Once you have had that discussion, you both need to sign and date the assessment. You should complete a brief summary of the discussion. It is your responsibility to ensure that each completed assessment form has all required documentation, including the name, and dated signature of your assessor as well as your dated signature. Your supervisor will provide you with a copy of the completed assessment form. You will then upload the OCCA and all completed competency assessments into the Moodle assessment item.

It is your responsibility to ensure that you remind your clinical supervisor at least one week prior to the assessment that it needs to be done, and book a meeting with him/her toward the end of the week that the assessment is due. This gives your supervisor the opportunity to collect and review feedback. Competencies should be completed by week 10 so that the final summative OCCA meeting can take place in week 11 (due date on Moodle).

If there are extenuating circumstances at the clinical facility that prevent you from being assessed during the required weeks, you must contact the unit coordinator in a timely manner. This will require obtaining approval for an assessment extension via the unit Moodle site. It is also your responsibility to ensure regular access to the technology needed to upload your assessment by the submission due dates. In the absence of an approved assessment extension, if you have not met all of the requirements listed in the Assessment Criteria section by the stated due dates, you will fail this assessment, and because this is a pass/fail course that means you will receive a Fail grade for the unit.

On occasion, clinical sites inform us of student behaviours which either: compromise the reputation of the clinical site and/or the University, compromise patient / staff safety and/or well-being or breach the Code of Conduct for Chiropractors (examples of such behaviours include but are not limited to - data protection violations, radiation guideline violations, failure to complete file documentation, violation of approved treatment plans etc). In these instances students are notified that they must cease attendance at the clinical site and discuss their position with the unit coordinator and head of course. This may result in applying student behavioural misconduct procedures in line with the CQUniversity Student Behavioural Misconduct Procedure.

The criteria for assessment are detailed on the OCCA form, which details behaviours, attributes and competency assessments that will contribute to your score. The assessor will use the stated not assessed (NA), 0,1,2,3 or 4 point scale to indicate the frequency and extent to which you demonstrate each. The required behaviours, attributes and competency assessments are grouped into 7 sections (examples of material that will inform your score are detailed in bullet point form -this list is not exhaustive -see scoring indicators on Moodle for further information), each section has its own minimum required scores.

For Section 1: Professional Behaviour demonstrated during:

· Systemic examinations

· Treatment and examination competencies

· Daily observations

For Section 2: Communication during:

· History taking competency

· Physical examination competency

· Report of findings competency

· Adjustive technique competency

· Written interprofessional skills

· Communication within the clinic environment with peers and staff

· Daily observations

For Section 3: Patient Assessment during:

· History taking competency

· Physical examination competency

· Rehabilitation functional screen

· Physical examination planning discussions

· Daily observations

For Section 4: Clinical Reasoning and Planning during:

· History taking competency

· Physical examination competency

· Case summary presentations/discussions

· Case summary write ups

· Daily observations

For Section 5: Interventions / management during:

· Case summary presentations

· Case summary write ups

· Adjustive technique competency

· Rehabilitation skills

· Patient records management

· Daily observations

For Section 6: Evidence-based/informed Practice during:

· Case summary write ups

o Treatment plans

o Prognosis

o Outcome measures

· Report of findings competency

· Case management

· Daily observations

For Section 7: Documentation and risk management during:

· File audit competency 

· Interprofessional communication (verbal or written)

· Daily observations

For each of the 7 sections there are multiple required behaviours.

The minimum required score to be considered successful in the first (formative) OCCA:

· No more than one score of NA

· No scores of 0 or 1

· No more than 10 scores of 2

· All remaining scores must be 3 or higher

The requirements to successfully pass the second (summative) OCCA:

• No scores of NA or 1
• An overall score of 65%

In order to achieve an overall grade of 'Pass' in this assessment task, you must:

• Schedule and complete both the formative OCCA in week 6 and summative OCCA in week 11
• On the overall placement assessment, meet the minimum required scores in all seven sections and successful completion of all associated competencies
• Ensure the documentation of each OCCA is complete, signed and submitted via Moodle with all completed competencies and the OCCA via moodle in weeks 6 and 11

If minimum required scores in the formative OCCA are not met, you will be regarded as a "Student At Risk". The unit coordinator will contact you via email to advise you of the risk of failing CHIR20011 and provide formative feedback. You must respond to this email to show you understand the implications of this information and give details of your plans for immediate improvement. A phone call or visit will follow. If concerns continue, your supervisor or unit coordinator may request an OCCA, a review of your progress will be completed. Unsatisfactory scores at this second OCCA will result in a fail grade for CHIR20011.

When a student's behaviour is beyond acceptable risk to clinical sites (compromise the reputation of the clinical site and/or the University, compromise patient / staff safety and/or well-being or breaches the Code of Conduct for Chiropractors, or the the clinical sites policies and procedures), clinical supervisors are required to contact CQUniversity academics/unit coordinator immediately. An OCCA will be performed at this time, IF the outcome of this out of sync OCCA is unsatisfactory, and/or the site feedback indicates that they can no longer host you due to the risk incurred, then this one OCCA alone, or site refusal to host, will constitute a fail of CHIR20011. Where such risk exists your placement will terminate immediately. It is difficult to place such students in the clinical environment again. Your continued progress within the chiropractic course may be at risk.

During the term, clinical interns will be required to demonstrate an increasing level of competency in all aspects of clinical practice as described in the summative competencies. The supervisor will select from competent, requires improvement or incompetent in regards to individual performances - feedback will be provided.

All competency assessments must be successfully completed receiving a level of competency consistent with Clinical Practice 5 to pass the overall practical assessment activity. Minimal prompting or guidance from the clinical supervisor is acceptable, the competencies may be repeated if deemed necessary by the clinical supervisor. The competency forms will be available on Moodle and in the clinic for your reference.