CQUniversity Unit Profile.

This end of term test will be made up of a mix of long and short case scenarios that have a higher level of complexity than the scenarios tested in Chiropractic Practice 4. You will be required to provide answers demonstrating appropriate clinical reasoning, diagnosis and patient management. The test will take place in a computer lab on-campus and will be invigilated by a staff member. An information guide will be provided during the term to provide study and preparation tips.

Level of GenAI use allowed:
Level 1:  GenAI is not allowed in this activity. This assessment is to be completed entirely without AI assistance in a controlled environment, ensuring you rely solely on your existing knowledge, understanding and skills.

The 72-hour grace period does not apply to this assessment. 

This end of term test will require you to demonstrate your knowledge and clinical reasoning skills as described above. The assessment criteria will require you to select the correct answer for any MCQ questions. For the short or long answer questions, these will be marked by the UC and clinical educators. The requirements will involve accuracy of the answers, grammar, spelling and completeness. Feedback will be provided after the results are released.

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 terms 2 and 3. 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 Term 1. 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 total clinical requirements as detailed in the clinic manual (This term your target is 80 treatments, 15 new patient consultations, 2 systemic examinations, 10 radiology reports and 10 radiographic positioning encounters). 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*

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
2 report of findings
1 rehabilitation functional screen
1 electrical modality (to be scheduled for the group)
1 referral letter (to be signed off by supervisor)
1 patient centered management (will occur in conjunction with the OCCA discussions)
1 patient centered communication (will occur in conjunction with the OCCA discussions)
2 overall clinical competence assessments (OCCA) (one formative during week 8 and one summative which will be completed during week 11)
1 social media to be assessed, 4 to be completed for formative feedback
10 Radiology reports submitted and approved

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 around week 8. 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 final weeks of the placement (weeks 11-12). 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 weeks 11-12 (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, treating patients outside of the clinic without supervision 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.

Please note, this is a pass/fail assessment task that means if you do not achieve a pass for this task you will not pass the unit. Supplementary assessments are not available for pass/fail assessment items

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

PART A

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.

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:

Systemic examinations
Radiography competency
Patient centered management and communication competencies
Daily observations
For Section 2: Communication during:

History taking competency
Physical examination competency
Report of findings competency
Adjustive technique competency
Written interprofessional skills
Written health promotion 
Communication within the clinic environment with patients, 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
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
no more than 6 scores of 2
All other 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 8 and summative OCCA in week 11-12
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 with all completed competencies and the OCCA in weeks 8 and 11-12
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 4 to pass the overall practical assessment activity. Some 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.

Task A

You will be provided with a prompt to use within a GenAI service. The prompt will provide a comprehensive patient history. You will need to provide three differential diagnoses/ddx (properly written), perform a 'virtual' physical examination (detailing the physical exam including specific tests you would want to perform) with the information provided you will determine a working diagnosis and a chiropractic plan of management for the patient. The GenAI service will provide you with feedback on your ddx list, appropriateness of physical exam, your working diagnosis and your care plan. You will save a copy of this document to submit alongside a short (self-authored) reflection on the feedback about how you will apply it and or why you will not be applying it with clinical reasoning style justification. This will require you to critically reflect on your performance and the feedback provided to determine future steps for your development.

Task B

You will be provided with a prompt to use within a GenAI service. The prompt will provide a comprehensive patient history. You will need to provide three differential diagnoses/ddx (properly written), perform a 'virtual' physical examination (detailing the physical exam including specific tests you would want to perform) with the information provided you will determine a working diagnosis and a chiropractic plan of management for the patient. The GenAI service will provide you with feedback on your ddx list, appropriateness of physical exam, your working diagnosis and your care plan. You will save a copy of this document to submit alongside a short (self-authored) reflection on the feedback about how you will apply it and or why you will not be applying it with clinical reasoning style justification. This will require you to critically reflect on your performance and the feedback provided to determine future steps for your development.

Task C

You will be provided with a prompt to use within a GenAI service. The prompt will provide a comprehensive patient history. You will need to provide three differential diagnoses/ddx (properly written), perform a 'virtual' physical examination (detailing the physical exam including specific tests you would want to perform) with the information provided you will determine a working diagnosis and a chiropractic plan of management for the patient. The GenAI service will provide you with feedback on your ddx list, appropriateness of physical exam, your working diagnosis and your care plan. You will save a copy of this document to submit alongside a short (self-authored) reflection on the feedback about how you will apply it and or why you will not be applying it with clinical reasoning style justification. This will require you to critically reflect on your performance and the feedback provided to determine future steps for your development.

A rubric will be provided on Moodle.  These tasks will help you develop lifelong learning skills, critical analysis while also honing your clinical reasoning and management skills.

Level of GenAI use allowed:
Level 3 AI collaboration: You will need to use Al to act as a simulated patient, it will provide you with evaluative feedback about your performance. However, you may not use GenAI for the short critical reflection at the end of the activity. 

You will be assessed on the completion of each component described -providing a ddx list (3 in order of likelihood written in a proper diagnosis format), selecting and planning an appropriate physical exam, determining an appropriate working diagnosis and chiropractic care management plan. Followed by reflecting on the evaluative feedback provided by the Gen AI service. You will demonstrate your ability to critically reflect on the learning activities to identify strategies for improvement as required of a lifelong learner.