Welcome to this clinical rotation in Orthopaedics. The aim of this rotation is to give you the opportunity to refresh and practice your clinical skills which you have learned in the Musculo-skeletal module of Phase III. At the end of this module you should be able to do a clinical musculo-skeletal examination of a patient and interpret X-rays meaningfully.
Furthermore you will have the opportunity to apply your theoretical knowledge in the field of orthopaedics. After completion of this module, you should be able to confidently diagnose and appropriately manage the common clinical problems with which you will be confronted in practice. In addition you will gain skills in interventions such as the reduction of closed fractures as well as the application of Plaster Of Paris Casts to all routine fractures.
Some students will attend the Rural Clinical School in Worcester and have the opportunity to rotate through the Department of Orthopaedic Surgery at Worcester Hospital. The duty roster of the students allocated to district hospitals will be issued once they arrive at their respective hospitals. Please refer to the description of the Longitudinal Model of the Rural Clinical School. As there are no separate Orthopaedic Department or clinics in these centres, use will be made of portfolios of musculoskeletal patients. The student will be required to compile a portfolio of short and long term Orthopaedic cases. The portfolio will consist of a recording in the form of clinical notes of patients whom you have examined and in which management you were actively involved in, or have followed up. These patient studies may also be used for further questioning in your oral exams.
Students rotating at Tygerberg will also be rotating through the Division of Rheumatology. They will attend Rheumatology outpatients where they will have the opportunity to see some of the more common rheumatological conditions. They will also receive tutorials and have interactive sessions focussing on the rheumatological aspects of the musculoskeletal examination as well as the most important rheumatological conditions.
You must also pay attention to the profile of the Stellenbosch doctor as introduced in the manual.
The aim of the final two years of your course is to become knowledgeable and competent interns
REFERENCES AND TEXTBOOKS
The following are recommended:
1. Concise System of Orthopaedics and Fractures, AG Apley & L Solomons, ISBN 0750617675, (Butterworth and Heindmann Ltd.)
2. Apleys System of Orthopaedics and Fractures, Apley 3. Clinical Orthopaedic Examination, Ronald McCrae-Churchill Livingstone, 1983 4. Practical Fracture Treatment, Ronald McCrae 5. Physical Examination of the Spine and Extremities, Stanley Hoppenfeld
ISBN 0-8385-7853 6. Kumar and Clarke (Chapter on Rheumatology) 7. Rheumatology notes, 3rd year lectures 8. The Orthopaedic Physical Examination, Bruce Reider, ISBN 9780721674377, (WB Saunders
1. Departmental Website: http://www0.sun.ac.za/ortho 2. Web studies: http://webct.sun.ac.za Module: Late Clinical Rotations 541 and 687 (MS02363).
If you have trouble logging into this site, or the module is not listed please contact. email@example.com
3. Orthopaedic Department: http://www.sun.ac.za/orthopaedics 4. Orthogate: http://www.orthogate.org/ 5. Orthobullets: http://www.orthobullets.com/ 6. Wheeless Textbook: http://www.wheelessonline.com/ 7. Orthoteers: http://www.orthoteers.com/ (Subscription required) FULL-TIME LECTURERS
NAME OFFICE E-MAIL TEL Dr J du Toit C6 B West, TBH firstname.lastname@example.org 021-938 5458 Dr ICM Robertson C6 B West, TBH email@example.com 021-938 5458 Dr A Ikram C6 B West, TBH firstname.lastname@example.org 021-938 5458 Dr H de Jongh C6 B West, TBH email@example.com 021-938 5458 Dr S Pretorius C6 B West, TBH firstname.lastname@example.org 021-938 5458 Dr I Terblanche C6 B West, TBH email@example.com 021-938 5458 Dr G du Preez C6 B West, TBH firstname.lastname@example.org 021-938 5458 Dr JH Davis C6 B West, TBH email@example.com 021-938 5458 Dr D Burger C6 B West, TBH firstname.lastname@example.org 021-938 5458 Dr T Franken Worcester Hospital email@example.com 023-348 1100 Dr A Basson Worcester Hospital firstname.lastname@example.org 023-348 1100 Dr. A. Hess Caledon Hospital email@example.com 028-212 1070
NAME OFFICE E-MAIL TEL Dr Mou Manie Room 3127, clinical
building firstname.lastname@example.org 021 938 5527 / 5731
Dr Riette du Toit Room 3071, clinical building
email@example.com 021 938 5527 / 5731
Dr Dave Whitlelaw Room 3062, clinical building
firstname.lastname@example.org 021 938 5527 / 5731
Dr Lisa du Plessis Room 721 , TBH email@example.com 021 938 5527 / 5731 Dr Robert Cooper Room 721 , TBH 021 938 5527 / 5731 Dr Joe Latief Room 3067, Clinical
Building firstname.lastname@example.org 021 938 5527 / 5731
ASSESSMENT DURING CLINICAL ROTATION A. Tygerberg Students
1) Assessment during the module 2) Knowledge/skills 3) Written test 4) OSKE on last day of rotation
INTEGRITY ASSESSMENT DURING THE MODULE COMPRISES THE FOLLOWING: 1. Presence (attendance must be 90%) 2. Punctuality 3. Interest (evident from questions asked) 4. Initiative (read up, suggestions) 5. Empathy with patients 6. Involvement 7. Studiousness 8. Human relationships (patients, nursing staff and co-students) 9. Ability to be an effective member of a team
These will be assessed and contribute 10% of the class mark.
NB: All students must submit a photo of themselves (including their name and student number) on a PowerPoint Presentation Slide to Me Veronica Marthinus (Veronica.Marthinus@westerncape.gov.za) WITHIN the first 7days of your rotation! The Orthopaedic Registrar Representative will use these photos for the INTEGRITY ASSESSMENT
KNOWLEDGE/SKILLS 1. Written test paper consisting of short questions at the end of the 4th week (This contributes
40% of the class mark, only students at Tygerberg need write.). This will test the students theoretical knowledge (Musculoskeletal lectures, including Rheumatology Middle Clinical Rotation given in 3rd year) as well as knowledge of plaster casts, splinting and traction, and clinical problems such as prevention of deep venous thrombosis and pressure ulcers. Oral and Clinical Tests (OSKE)
a) Tygerberg and Worcester Students: OSKE at the end of the rotation (usually the fifth week), consisting of an oral which includes a long clinical case. This assessment contributes to 50% of the class mark. (60% for the RCS students)
ASSESSMENT DURING CLINICAL ROTATION
B. Longitudinal Model Students
Assessment will include the following:
1. Continuous evaluation mark 2. Portfolio Evaluation. 3. OSKE
Portfolio evaluation mark
The portfolio exam accounts for this mark. It will count 40% towards the class mark.
Portfolio. Details of the portfolio are given on page 16.
The Worcester and Longitudinal model students will not have to undergo the written test. The 40% allocated to this test (presently written by the Tygerberg Students) will be used for the portfolio assessment.
Longitudinal model students are encouraged to come to Tygerberg Hospital and sit in at up to 2 OSKE tests as preparation and as a practise session- These (voluntary) assessments will not count towards your marks. Arrange with Tygerberg Hospital (Helga -Tel 021-938-9266) at least 2 weeks before an OSKE scheduled for Tygerberg students. Longitudinal Model students must partake in one OSKE at Worcester (to be held at least 2 months before the final examination). This assessment contributes 50% towards the class mark.
MARK ALLOCATION TYGERBERG MARK ALLOCATION - RCS
Class Mark: Class Mark:
OSKE test 50% OSKE test 60% Written Test or Portfolio 40% Portfolio 32% Integrity Assessment 10% Intraining progress report 8%
Final Exam 50%* Class Mark 50%
*It is essential to pass this final exam (OSKE). Students who fail to pass this OSKE will be offered an additional OSKE within 48 hours of publication of the final mark. If this is unsuccessful the rotation may have to be repeated the following year.
Each group will rotate through the Division of Orthopaedic Surgery for 5 weeks. Rheumatology clinic
visits and tutorials are scheduled for week 1-3, as per roster. (See information booklet for late clinical
rotations for details of groups.) As from August both 5th and 6th year students will be in the group
rotating through the Division of Orthopaedic Surgery. The clinical assessment evaluation (OSKE) will
normally take place on the last Friday of the rotation. This evaluation will be scheduled 1 week earlier
in April (6th years) and November (both 5th and 6th years) to accommodate the exams.
In 2013 the OSKE clinical exams will be 15, 16 & 17 April 2013 and 18, 19 & 20 November 2013.
During the final OSKE, students may be given a rheumatologic case / oral examination as part of their
The outcome is a student who can competently enter internship and he/she has mastered adequate clinical and cognitive skills to manage emergencies that they may encounter and also to stabilise these before referral. He/she must be able to compete