MBBS THEME IV - Year 5D Content Guide Summary

Performs in a simulated environment

Performs in the clinical environment on a real patient under direct and structured supervision
Observes in a clinical environment
Performs and/or interprets results from expert report and plans appropriate management under structured
supervision
Capable of performing and accurately interpreting results of investigations/reports and planning appropriate
management with appropriate supervision
IMPORTANT NOTES:
Some specific sites, locations and contexts may require closer supervision than indicated. Students are responsible
for finding appropriate supervisors for performance of tasks in clinical environments.
TARGET ACHIEVEMENT LEVEL BY END OF YEAR

HISTORY, EXAMINATION AND COMMUNICATION SKILLS

Consulting/ Communication Skills Conduct a structured and organised patient centred interview:
Commencing the interview
Gathering information
Explanation and planning
Closing the interview
Motivational Interviewing
Basic counselling skills to assist patients
Useppropriate communication skills for dealing with patients from
diverse cultural and social backgrounds
Elicit a structured, comprehensive and logical history for neonates,
babies, children, adolescents, adults and elderly inlcuding:
Presenting complaint
Past medical/surgical history
Family history
Social history
Systems review
Medications
Allergies
Nutrition/diet
Drug, alcohol and smoking history
Focused history and examination skills - Appropriate clinical history and physical/mental state examination skills
(relevant to practice in general practice, psychiatry, women's health and
children's health) for:
MUSCULOSKELETAL Musculoskeletal
CARDIOVASCULAR Cardiovascular
Haematological
RESPIRATORY Respiratory
GASTROINTESTINAL Gastro-intestinal

KEY CONTACTS:
jennifer.lindley@monash.edu
julia.harrison@monash.edu 1
MBBS THEME IV - Year 5D Content Guide Summary
Performs in a simulated environment
Performs in the clinical environment on a real patient under direct and structured supervision
Observes in a clinical environment
Performs and/or interprets results from expert report and plans appropriate management under structured
supervision
Capable of performing and accurately interpreting results of investigations/reports and planning appropriate
management with appropriate supervision
IMPORTANT NOTES:
Some specific sites, locations and contexts may require closer supervision than indicated. Students are responsible
for finding appropriate supervisors for performance of tasks in clinical environments.
TARGET ACHIEVEMENT LEVEL BY END OF YEAR
NEUROLOGICAL Neurological
Glasgow Coma Scale (GCS) scoring
Papilloedema identification (ADV.)
ENDOCRINE Endocrine
UROGENITAL Renal and urological
Urine dipstick test
REPRODUCTIVE SYSTEM Accurate clinical history and physical examination for sexual health and
reproductive system for males and females
Women's Health Breast examination Hx & exam
Men's Health Testicular examination
MENTAL HEALTH Mental State Examination
Mini-mental state examination
ENT Ear, Nose and Throat
Opthalamic history and eye examination
Visual field assessment
Visual acuity assessment
Direct ophthalmoscopy
Slit lamp use
DERMATOLOGICAL Dermatological history and examination

TRAUMA Primary trauma survey

Peripheral neurovascular assessment
Secondary trauma survey
PAIN ASSESSMENT Full pain assessment including the use of pain scales

GERIATRIC ASSESSMENTS Assess significant and/or common geriatric conditions

Assess participation restrictions, activity limitations, personal factors
and environmental factors (geriatrics)
Assess older person’s suitability for an unrestricted driving licence.
Assess an older person’s risk of nutritional deficiency
Assess the risk of poly-pharmacy in an older person

KEY CONTACTS:
jennifer.lindley@monash.edu
julia.harrison@monash.edu 2
MBBS THEME IV - Year 5D Content Guide Summary
Performs in a simulated environment
Performs in the clinical environment on a real patient under direct and structured supervision
Observes in a clinical environment
Performs and/or interprets results from expert report and plans appropriate management under structured
supervision
Capable of performing and accurately interpreting results of investigations/reports and planning appropriate
management with appropriate supervision
IMPORTANT NOTES:
Some specific sites, locations and contexts may require closer supervision than indicated. Students are responsible
for finding appropriate supervisors for performance of tasks in clinical environments.
TARGET ACHIEVEMENT LEVEL BY END OF YEAR
PRE-OPERATIVE ASSESSMENTS Assess the medical fitness of a patient for an operation
ACUTELY ILL/DETERIORATING PATIENT Recognises the vital signs indicating deterioration of patient
(“MET CALL”) Assessment of acutely ill, deteriorating or dying patients
UNCONCIOUS PATIENT Conduct a physical examination of an unconscious patient

PROCEDURAL SKILLS
GENERAL
Measurement Height, Weight, BMI
Temperature measurement
Blood pressure measurement
Pulse oximetry reading
Intravenous Venepuncture
Intravenous cannulation
Intravenous infusion set up
Intravenous drug administration
Intravenous fluid & electrolyte therapy
Diagnostic Blood sugar estimation (glucometer)
Collect blood culture specimen
Simple swab -standard micro collection
Wound swab
Injections Intramuscular injections
Subcutaneous injections
Intravenous injections
Joint aspiration or injection
Respiratory Oxygen therapy
Nebuliser/inhaler therapy
LMA and ETT placement

KEY CONTACTS:
jennifer.lindley@monash.edu
julia.harrison@monash.edu 3
MBBS THEME IV - Year 5D Content Guide Summary
Performs in a simulated environment
Performs in the clinical environment on a real patient under direct and structured supervision
Observes in a clinical environment
Performs and/or interprets results from expert report and plans appropriate management under structured
supervision
Capable of performing and accurately interpreting results of investigations/reports and planning appropriate
management with appropriate supervision
IMPORTANT NOTES:
Some specific sites, locations and contexts may require closer supervision than indicated. Students are responsible
for finding appropriate supervisors for performance of tasks in clinical environments.
TARGET ACHIEVEMENT LEVEL BY END OF YEAR
TRAUMA Immobilisation of cervical spine
Cervical collar application
Volume resuscitation
Plaster cast/splint limb immobilisation
Joint relocation
Intercostal catheter insertion
LIFE SUPPORT Basic Life Support (DRSABCD)
External cardiac massage
Cardiopulmonary resuscitation (CPR)
Airway management (as per ARC guidelines)
Basic airway opening
Bag and mask ventilation
Advanced Life Support (as per ARC guidelines)
- Defibrillation
- Manage bleeding
Pressure haemostasis
CARDIOPULMONARY 12 lead electrocardiogram recording
Arterial blood gas sampling
Venous blood gas sampling
Peak flow measurement
Spirometry
Pleural effusion/pneumothorax aspiration
Central venous line insertion
GASTROINTESTINAL Nasogastric tube insertion
Rectal examination
Anoscopy/proctoscopy
Abdominal paracentesis

KEY CONTACTS:
jennifer.lindley@monash.edu
julia.harrison@monash.edu 4
MBBS THEME IV - Year 5D Content Guide Summary
Performs in a simulated environment
Performs in the clinical environment on a real patient under direct and structured supervision
Observes in a clinical environment
Performs and/or interprets results from expert report and plans appropriate management under structured
supervision
Capable of performing and accurately interpreting results of investigations/reports and planning appropriate
management with appropriate supervision
IMPORTANT NOTES:
Some specific sites, locations and contexts may require closer supervision than indicated. Students are responsible
for finding appropriate supervisors for performance of tasks in clinical environments.
TARGET ACHIEVEMENT LEVEL BY END OF YEAR
SURGICAL Handwashing/prep for sterile procedures
Scrub, gown & glove
Assisting in the operating theatre
Surgical knots & simple wound suturing
Local anaesthesia
Simple skin lesion excision
Suture removal
Complex wound suturing
NEUROLOGICAL Lumbar puncture
EAR, NOSE & THROAT Throat swab
Anterior nasal pack insertion
Auroscopy/otoscopy
External auditory canal irrigation
External auditory canal ear wick insertion
FB removal - ear & nose
OPHTHALMIC Eye drop administration
Fluorscein - staining of cornea
Eye irrigation
Eyelid eversion
Corneal foreign body removal
Intraocular pressure estimation
UROGENITAL Bladder catheterisation (Male &Female)
Urine dipstick interpretation
WOMEN’S HEALTH Urine pregnancy testing

KEY CONTACTS:
jennifer.lindley@monash.edu
julia.harrison@monash.edu 5
MBBS THEME IV - Year 5D Content Guide Summary
Performs in a simulated environment
Performs in the clinical environment on a real patient under direct and structured supervision
Observes in a clinical environment
Performs and/or interprets results from expert report and plans appropriate management under structured
supervision
Capable of performing and accurately interpreting results of investigations/reports and planning appropriate
management with appropriate supervision
IMPORTANT NOTES:
Some specific sites, locations and contexts may require closer supervision than indicated. Students are responsible
for finding appropriate supervisors for performance of tasks in clinical environments.
TARGET ACHIEVEMENT LEVEL BY END OF YEAR

Select relevant investigations for the patient's presenting problems or

DIAGNOSTIC PROCEDURES
conditions
INVESTIGATIONS Select relevant investigations for the patient's presenting problems or
conditions
Requests/orders relevant investigations correctly
Interpret results of investigations
SPECIFED INVESTIGATIONS
ECG VT
AF
VF
A flutter
Complete heart block
SVT
Ischemia
Artefact
Bundle branch block
Cardioversion
Defibrillation
Imaging
X-RAYS CXR
Abdo
MSK (all limbs)
Pelvis
Cervical
Thoracic
Lumbar
Facial
Skull

KEY CONTACTS:
jennifer.lindley@monash.edu
julia.harrison@monash.edu 6
MBBS THEME IV - Year 5D Content Guide Summary
Performs in a simulated environment
Performs in the clinical environment on a real patient under direct and structured supervision
Observes in a clinical environment
Performs and/or interprets results from expert report and plans appropriate management under structured
supervision
Capable of performing and accurately interpreting results of investigations/reports and planning appropriate
management with appropriate supervision
IMPORTANT NOTES:
Some specific sites, locations and contexts may require closer supervision than indicated. Students are responsible
for finding appropriate supervisors for performance of tasks in clinical environments.
TARGET ACHIEVEMENT LEVEL BY END OF YEAR
CT SCANS for major abnormalities, SOL, internal bleeding in:
Head
Thoracic
Abdominal
MRI MRI
Ultrasound Ultrasound
Echocardiogram Echocardiogram
Holter monitor Select and arrange Holter monitor
Blood pressure Blood Pressure Tests
Hypertension
Hypotension
Postural hypotension
24 hr monitoring
Pathology Haematology
Microbiology
Biochemistry
Histopathology (bx)
Cytology
Endoscopy Upper GI
Colonoscopy

KEY CONTACTS:
jennifer.lindley@monash.edu
julia.harrison@monash.edu 7
MBBS THEME IV - Year 5D Content Guide Summary
Performs in a simulated environment
Performs in the clinical environment on a real patient under direct and structured supervision
Observes in a clinical environment
Performs and/or interprets results from expert report and plans appropriate management under structured
supervision
Capable of performing and accurately interpreting results of investigations/reports and planning appropriate
management with appropriate supervision
IMPORTANT NOTES:
Some specific sites, locations and contexts may require closer supervision than indicated. Students are responsible
for finding appropriate supervisors for performance of tasks in clinical environments.
TARGET ACHIEVEMENT LEVEL BY END OF YEAR
Cardiopulmonary Doppler and duplex - vascular
Angiography
Arterial blood gas
Venous blood gas
Spirometry
Peak flow meter
Pulse oximetry
Bone densiometry report
Growth Height, weight and BMI
Accurately plot growth parameters on a growth chart, and interpret
these measures.
Urogenital Urine dipstick interpretation
Hearing Interpret an audiogram

MANAGEMENT & CLINICAL REASONING

Prioritisation Recognise common and significant clinical condicitons
Identify and assimilate common presenting problems in patients
Prioritises patient care in order of priority
Adapts care in response to changes in clinical condition
Problem formulation Generate a ranked problem list
Apply diagnostic approach to assess undifferentiated presentations
Apply diagnostic approach to problem solving for patients with ‘vague
symptoms’ or undifferentiated presentations
Differential diagnoses Develop a differential diagnosis (list) and justify the most likely options
relevant for the patient
Investigations Justify selection of investigations for the patient's presenting problems
or conditions
Use results of investigations to guide patient management
Management Options Develop and justify management plans for common problems and
conditions
Develop management plan for a patient whose illness remains
undifferentiated

KEY CONTACTS:
jennifer.lindley@monash.edu
julia.harrison@monash.edu 8
MBBS THEME IV - Year 5D Content Guide Summary
Performs in a simulated environment
Performs in the clinical environment on a real patient under direct and structured supervision
Observes in a clinical environment
Performs and/or interprets results from expert report and plans appropriate management under structured
supervision
Capable of performing and accurately interpreting results of investigations/reports and planning appropriate
management with appropriate supervision
IMPORTANT NOTES:
Some specific sites, locations and contexts may require closer supervision than indicated. Students are responsible
for finding appropriate supervisors for performance of tasks in clinical environments.
TARGET ACHIEVEMENT LEVEL BY END OF YEAR
Therapeutics Selects the most appropriate medication for the patient including
empirical choice of 'best guess' antibiotic
Calculates or determines the correct dose and mode of administration
for the patient using accredited reference materials
Justifies their choice of prescribed medication for the patient
Pain management Select and justify analgesia therapeutics
Pre-procedure Perform admission
Post-procedure Monitors the patient & provides appropriate aftercare
Plans and justifies immediate response for common complications
Fluid & electrolyte management Develops and implements an individualised patient management plan
for fluid, electrolyte and blood product use
Ambulatory & community care Identifies and arranges ambulatory & community care services
appropriate for each patient
Discharge planning Prepares for effective patient discharge including ambulatory and
community care according to guidelines
Complete discharge summary/letter
Referral & consultation Complete a referral letter
Case presentation Provides structured and effective case presentations and justifies
reasoning
Documentation Accurately records case details and clinical activities in appropriate
formats

KEY CONTACTS:
jennifer.lindley@monash.edu
julia.harrison@monash.edu 9