The Department of Primary Health Care and General Practice is involved in teaching students at all levels in the Advanced Learning in Medicine (ALM) course in Wellington. Students attend the Wellington campus for ALM years 4, 5 and 6 of the MBChB degree.
Advanced Learning in Medicine (ALM)
The ALM course is modular with rotating block modules through the three years and vertical modules running throughout the course.
The Department is responsible for the block modules in primary health care and general practice in all three years of ALM. These block modules are further described below and allow continuity though the ALM program. The vertical module Professional Skills, Attitudes and Ethics (PSAE) is also convened and administered in this Department. Two other vertical modules: Addiction Medicine and Clinical Reasoning have close links with the Department as well.
Teaching in the Department is research informed and also drives educational research. Recent research topics have included the teaching of Chronic Condition Management , Palliative Care teaching , Interdisciplinary teaching , and the teaching of Genital Examination. The courses are regularly evaluated and changes made as needed.
General practice is taught in conjunction with Public Health – each discipline taking primary responsibility for 5 weeks of the combined 10 week module. This involves clinical tutors in the community, as well as tutors from a number of different disciplines within the School
This block module is based on the Wellington campus. Although only 2 weeks in duration it allows for consolidation of principles of Primary Health Care and General practice and preparation for the extended clinical placement in the Trainee Intern year.
Students are exposed to concepts considered to be advanced general practice such as travel medicine and management of sexual assault and injecting drug users. There is also a strong emphasis on professionalism including communication, interdisciplinary practice and medicolegal issues.
Clinically focussed preparation for the TI year includes skills such as prescribing and minor surgery, as well as clinical examination teaching for genital examination and common musculoskeletal conditions.
The Trainee Intern General Practice module is a 6 week module, plus one week equivalent of Urgent Care experience which may be co-located or a stand-alone week.
Contracts are in place with a number of teaching practices in rural areas and provincial towns in the lower North Island to ensure you get the quality teaching and good clinical experience necessary to meet the educational objectives of this module. Trainee Interns are sent placement options in August of the previous year.
Tairāwhiti Interprofessional Education Programme (TIPE)
Health Workforce NZ is funding this collaborative project with several training partners - the University of Otago (UoO) and Eastern Institute of Technology (EIT) in Tairāwhiti. This very successful programme brings undergraduate students from eight different health disciplines together to learn and gain clinical experience working with Māori communities and other health providers in rural New Zealand. The IPE programme has now completed the pilot and Health Workforce NZ has announced continued support until 2018
TIPE is a fully interprofessional programme for senior health professional students started in 2012 which includes students from Medicine, Nursing, Occupational Therapy, Pharmacy, Physiotherapy, Dietetics, Dental and Oral Health students all in their final year courses. Trainee Interns are resident in Tairāwhiti or Wairoa for 6 or 7 weeks and will have a general practice clinical home whilst in Tairāwhiti. The IPE portion of the programme is for 5 weeks and is designed to provide a variety of experiences within a students own discipline, with other disciplines and within a variety of settings, (e.g. rural, chronic conditions management, and hauora Māori).
All University of Otago medical students immerse in a small town or area (in small groups across South Island and lower North Island) during one week to learn as much as they can about that community and how wider health and social needs are being met within each of these smaller towns and areas . These are not solely health care based visits and specifically include social and community agencies as the determinants of health are largely influenced by factors outside the remit of health care. Each of the Three Otago Medical Schools (Dunedin, Christchurch and Wellington) place about 95 students, usually in the third week of August each year. Community Contact Week involved 3rd year pre-clinical medical students
Wellington CCW has been in place in its current form since 2009 and students are placed in one of the following areas: Newtown and surrounding areas, Porirua, Kapiti Coast, Wanganui, Palmerston North, Wairarapa, and Lower Hutt.
While in that area for the week, the student assess the needs of that particular community (appreciative enquiry). This is an important aspect of being a doctor; learning how context and environment are crucial in causing and preventing ill health.
What do the students get from these placements?
"All of my experiences in the community were extremely positive, and I felt everyone made us feel very welcome. I think experiences such as these are all too rare in our course, and this program was by far the most enjoyable part of the third year course thus far."
"Seeing the problems in the community caused by gaps in the healthcare system. Also, witnessing the effects of domestic violence and substance abuse upon families."
"Gaining an understanding how different health organisations work together to care for patients, particularly outside of hospital. It was also really great to have some real world experience with patients that never end up in hospital, but still need a lot of care."
"Getting to meet such a variety of people from different organisations. I really enjoyed the wide range that we visited such as the fire service, which was a really amazing experience, and then the farming school, the physio and the GP. It allowed me to get a variety of perspectives and I learnt something different from each place"
This is a “Vertical Module” with curriculum time allocated through years 4, 5 and 6. The module is convened Dr Ben Gray and co-taught with Dr Angela Ballantyne, the bioethics senior lecturer. We introduce students to an ethical decision making framework that it used through the programme to help them to break down clinical ethics scenarios and understand how to integrate ethical principles into healthcare practice. Ethical issues are part of all clinical practice – in everyday, extraordinary and controversial situations. Teaching is through a mixture of whole class lectures, tutorials in groups of 18, and reflective small discussion groups focusing on professionalism (6 members). Assignments include a set formal ethics essay in 4th year, and a clinical ethics essay in 5th year based on students own experience; a 4th year joint group assignment completing a the ethical decision making framework; “Thought Provoking Episode Reports” TPER in 4th and 5th year (for which individual oral feedback is given), and a written reflective piece responding to the book the Spirit Catches You and You Fall Down. The curriculum covers material on health law, and on main bioethical themes – research, tissue donation, genetics, ethics and the elderly, ethics and children, abortion, and mental health. Professionalism teaching looks at trust, healing, the student code of practice, advocacy for patients, how to manage patient confidentiality and discussion of issues that the students encounter through the small groups and the TPER’s. We collaborate closely with the convener of Clinical Reasoning to enable to students to put it all together and make good ethical and clinical judgments. We aim to develop critical thinkers who can identify ethical issues, weigh competing values, and justify their decisions with reasoned arguments.