PART A -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.

Interns will have the opportunity at the discretion of the clinic supervisor and unit coordinator to go on an external clinical placement for a maximum of 4 weeks during November and December. This will be decided based on the students’ progress towards reaching their clinical requirements and assessments. Please note there will not be an opportunity to do an external placement during January. Interns will be responsible for ensuring all components of the Work Integrated Learning (WIL) agreement is completed in advance.

During your time in clinic, you MUST complete your clinical requirements as detailed in the clinic manual (This term 100 treatments, 15 new patients consultations, 2 systemic examinations, 20 radiology reports 10 radiographic positioning encounters and 3 lab investigations and/or meet the final totals required for the year of 300 treatments, 50 new patient consultations, 6 systemic examinations for each system, 60 radiology reports, 30 radiography positioning and 10 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.

PART B - 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 ortho examination
• 1 neuro examination
• 1 systemic examination
• 3 adjustive techniques
• 1 report of findings
• 1 rehabilitation functional screen
• 2 professionalism competencies (weeks 5 and 10)
• 2 file audits
• 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.

PART A

To pass this assessment you must achieve a minimum of 168 hours (12 X 14 hours - 3.5hrs x 3 clinic shifts/week, 3.5hrs x 1 radio/recept shifts/week) of clinical attendance 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.

PART B

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:

· Professionalism competency weeks 5 and 10

· Systemic examinations

· Radiography competency

· 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 x 2

· Professionalism competency weeks 5 and 10

· 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 4 scores of 2

· All remaining scores must be 3 or higher

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

• no scores of NA
• All sections must be scored at 3 or higher

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 CHIR20013 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 CHIR20013.

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 CHIR20013. 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.

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, listing your 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 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

Junior clinic is an opportunity for near-peer learning, across the four weeks of junior clinic, you will be mentoring incoming students. This provides a prime opportunity to reflect briefly on your development over the past year, you will also be able to identify and explore areas that have been challenging during your professional development. This should be referenced and no more than 300-500 words.

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, you are then required to post your item to the weekly forum with a critique of the 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

Following junior clinic, this activity requires a brief critical reflection (300-500 words) on your own professional development across the past year. It is expected that this reflection will be linked to your observations during junior clinic and your own experiences over the past 10 months. It should be referenced and submitted via moodle with a link to your mahara page. Failure to do 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.

The clinic exit examination will involve a two day examination of your clinical skills and knowledge. It will consist of:

• One Objective Structured Long Examination Record (OSLER) station that will last for 35 minutes. This will follow the standard template (see moodle) and involve working through a new case consultation, examination skills, further investigations, management and theory.
• One VIVA (oral) station that will last up to 60 minutes. You may be provided with a case scenario 15 minutes prior to entering the viva for your perusal. The viva will involve examination of clinical knowledge and reasoning, ethics, synthesis of information, evidence informed management. It will also examine familiarity with the professional code of conduct and overall professional attitude.

While this is a P/F assessment a score of 65% or above is required to pass. A detailed marking rubrics will be available on moodle no later than week 6 of the term.

Please note:

You must present for your individual practical assessment dressed as you would present to the clinical environment. Any student not adhering to the dress code may be excluded from the assessment.

Non-Academic reviewers may be present as part of the examining panel in addition to academic members of the team

This assessment task may be recorded using a video camera to enable moderation

Please note the following advice from the University Assessment of Coursework Procedures:

3.2.6 In non-graded (pass-fail) courses, all assessment items must be submitted by the due date, as there is no opportunity to apply a five per cent penalty, due to the pass-fail nature of each assessment task. Students who fail a single assessment task in a pass-fail course, or who fail a pass-fail component of a graded course will be deemed to have failed that course.

This assessment task must be completed on the specified day and time. In the absence of an approved extension, there will be no opportunity to complete the task after this date, and there will be no opportunity to apply a late penalty of five per cent per day.

The clinic exit examination is made up to two components - an OSLER (35 mins) and a VIVA (up to 60 minutes), rubrics and templates will be provided on Moodle.  Interns will be expected to arrive dressed appropriately for their time slot.  The examination will assess all items discussed above in the description.  It will also aim to confirm the following at the level expected of an entry level chiropractor in line with the standards set by the Council on Chiropractic Education Australasia:

• Able to perform a history that provides diagnostically relevant content
• Demonstration of clinical skills at the level of an entry level chiropractor
• Ability to interpret patient data and perform clinical reasoning
• Ability to synthesize patient information to create an evidence informed plan of management
• Demonstration of awareness and understanding of professional behaviour, scope and practice

A rubric will be provided by week 6 of the unit.