Relevant Auckland MBChB Learning Outcomes

Science and Scholarship: medical graduate as scientist and scholar
1.2: Apply core medical and scientific knowledge to individual patients, populations and health systems.
MBChB Graduate Learning Outcomes
 Applied Science for Medicine
Graduates will, with a broad scientific body of knowledge encompassing biological, behavioural and social sciences:
 •  Apply the scientific body of knowledge appropriately to common and important clinical problems and to the management of patients;
 •  Apply scientific principles, research methodologies and evidence to improve practice and the health of individuals and communities.
 Population Health
To guide practice and to improve health care in New Zealand, graduates will:
 •  Identify feasible strategies to improve health that incorporate the broader determinants of health at community and population level;
 •  Apply the principles of health promotion, population screening and disease management involving individuals and populations to a range of health care settings.
MBChB 221: Principles of Medicine
 Applied Science for Medicine
1 •  Identify basic disease processes during cadaver dissection and describe clinical-pathological correlations related to these processes, with reference to material available in the Medical Sciences Learning Centre.
3 •  Use oncology clinical scenarios as examples of the application of core biomedical knowledge to clinical situations.
 Clinical and Communication Skills
5Demonstrate understanding of the clinical relevance of basic biomedical principles.
 •  Explain how pathological science is placed into the context of patient care, assessment and treatment.
 •  Describe clinically-relevant genetic laboratory techniques.
 •  Discuss how cultural issues along with counselling and ethical principles guide patient care, using examples from clinical genetics.
 Population Health
9In a General Practice setting, identify elements of the consultations observed that have relevance to other Learning Outcomes for this course.
MBChB 221: Professional and Clinical Skills 1
 Population Health
11 •  Outline behaviours that adversely impact on health and describe interventions to alter behaviours at both the level of the population and the individual
MBChB 221: Musculoskeletal System
 Applied Science for Medicine
2 •  Interrelate structure and function of lower motor units, in selected common and important conditions.
 •  Relate findings on electromyography and nerve conduction studies to the physiology of neuromuscular control.
 Clinical and Communication Skills
6Identify on the living human, and using diagrams, the dermatomes of the body.
8Describe important anatomical considerations relating to common clinical procedures.
MBChB 221: Digestive System
 Applied Science for Medicine
1 •  Link the abnormalities of structure and function to their clinical and radiological presentations.
2 •  Relate the digestive and metabolic pathways to common associated disorders.
 •  Link the disorders from various nutrient deficiencies to their clinical presentations.
3Describe the integration of the gastro-intestinal function during the normal response to a meal.
4Outline the relationship between under- and over-nutrition of specific macro and micronutrients and nutritional disorders.
 •  Explain the role of recommended daily intake (RDI) for macro and micro nutrients in health and compare with those for acute and chronic disease states.
MBChB 221: Respiratory System
 Clinical and Communication Skills
6Use experiential physical examinations in CSC to:
 •  Describe and interpret findings of normal clinical examinations.
 •  Describe and justify a systematic approach to clinical examinations.
 •  Correctly use equipment and perform selected procedures.
 •  Take a history of a presenting complaint with some medical & social context.
7Summarise the symptoms, main physical findings and imaging results to describe common and important abnormalities of the respiratory system.
 Hauora Māori
13Identify the prevalent respiratory conditions in the Māori population, and feasible strategies for their prevention.
MBChB 221: Cardiovascular System
 Applied Science for Medicine
1Apply knowledge of basic anatomy, physiology, pathology, and pharmacology of the cardiovascular system to:
 •  Describe the structure of the system and relate these structures to their function at body, organ, tissue, cellular and molecular levels.
 •  Describe the determinants of vascular function and systemic blood pressure.
2Apply knowledge of basic anatomy, physiology, pathology, and pharmacology of the cardiovascular system to:
 •  Use appropriate physiological models of cardiac and vascular function to analyse and describe the status of a person’s cardiovascular system.
 •  Use the relationships between cardiac and vascular function to describe changes in the cardiovascular system under differing physiological and pathological conditions.
 •  Describe the changes in microvascular function during common cardiovascular pathologies.
3Apply knowledge of basic anatomy, physiology, pathology, and pharmacology of the cardiovascular system to:
 •  Describe the multiple factors that influence the heart and cardiovascular function under normal and pathologic conditions.
 •  Describe the pathological processes involved in a variety of common conditions involving the cardiovascular system.
 •  Discuss the relationship between pathological processes and the changing function of the system.
 •  Trace how the pathology of the major diseases links to clinical presentation.
 •  Describe the impact of common cardiovascular disorders on cardiovascular function tests.
4Discuss the mechanism of action and physiological effects of a small number of drugs used in common cardiovascular conditions.
5Link normal and abnormal embryological development of the heart to common and significant clinical problems and presentations.
6Discuss the role of psychological factors in the development of and recovery from cardiovascular disorders, particularly myocardial infarction.
 Clinical and Communication Skills
7Use experiential physical examinations in CSC to:
 •  Identify cultural factors and beliefs that influence physical examinations.
 Hauora Māori
15Identify the prevalent cardiovascular conditions in the Māori population, and feasible strategies for their prevention.
MBChB 221: Genitourinary System
 Applied Science for Medicine
1Apply knowledge of basic anatomy, physiology, biochemistry and pharmacology of the systems of the genitourinary tract to:
 •  Explain the anatomical interrelationships of the components of the genitourinary system and related glands and hormones, in male and female.
 •  Relate the structure of the urinary system to its function at organ, tissue, cellular and biochemical levels in healthy and diseased states.
 •  Discuss the role of the kidney in homeostasis of the volume, electrolytes and osmolarity of the body fluid.
 •  Outline the mechanisms of renal failure, haematuria, proteinuria and the pharmacological basis of selected therapeutic interventions.
 •  Correlate anatomical knowledge in situ and in sectional planes with common images from a range of modalities (Range: Plain radiological films; MRI median sagittal and axial planes; CT scan; Ultrasonography).
 Clinical and Communication Skills
3Use experiential physical examinations in CSC to:
 •  Describe and interpret findings of normal clinical examinations.
 •  Describe and justify a systematic approach to clinical examinations.
4Diagnose common clinical presentations by interpreting radiological images.
MBChB 221: Clinical Pharmacology
 Clinical and Communication Skills
3 •  Explain the information patients and medical practitioners need before prescribing a medicine.
MBChB 321: Nervous System
 Clinical and Communication Skills
7Use the problem solving approach of “where is the lesion” and “what is the lesion” to study selected neurological disorders.
8For selected neurological presentations and clinical findings, select the most appropriate initial investigations, including imaging modality.
 Population Health
11Identify risk factors, including social determinants, for selected neurological and psychiatric disorders.
12Describe the personal, population and economic impacts of neurological and psychiatric disease in New Zealand and how these might be lessened.
MBChB 321: Sensory Systems
 Applied Science for Medicine
1Apply basic knowledge of the anatomy, physiology, pathology and pharmacology of the systems located in the head and neck to:
 •  Relate clinical presentations to pathological processes in local structures.
 •  Predict the wide-reaching clinical effects of enlargement of selected structures of this system.
 •  Correlate appearances on selected imaging modalities with the underlying structures and pathology, both in situ and in sectional planes.
 •  Identify factors that change at different stages of life.
MBChB 321: Reproduction, Development and Aging
 Applied Science for Medicine
1 •  Explain how pregnancy may be detected.
3 •  Discuss current concepts of Aging.
 Population Health
7Describe NZ population demographics and outline some of the major impacts of its changing distribution on society and the health care system.
MBChB 321: Blood, Immunity and Infection
 Applied Science for Medicine
1Explain the key haematological parameters used in the diagnosis and treatment of disease.
2Outline the complications that may arise from transfusion and how they may be prevented.
3Explain the key immunological parameters used in the diagnosis of disease.
 •  Summarise, using supporting clinical examples, the positive and negative contributions of the immune system to health.
4Outline the principles of how infectious diseases may be diagnosed, treated and prevented, using appropriate examples of medically-important pathogens.
 Clinical and Communication Skills
7Solve clinically-based problems using integrated knowledge of haematology, immunology and microbiology, both independently and in groups.
MBChB 321: Regulation of Body Function
 Applied Science for Medicine
1Apply knowledge of the key mechanisms that underlie the regulation of major body organ systems to:
 •  Explain body fluid volumes and electrolyte content.
 •  Explain acid-base status.
 •  Explain the determinants and control of arterial blood pressure.
 •  Explain the control of breathing.
 •  Describe major effects of cytokines, hormones and neurotransmitters.
 •  Explain processes important in metabolism and their relationship to exercise.
2Develop a personal framework to comprehend and analyse the multi-factorial nature of the organ systems interactions in healthy and diseased states.
MBChB 321: Quality and Safety Project
 Clinical and Communication Skills
 •  Explain the concepts of error and violation in healthcare.
 •  Explain the difference between a person-oriented and a systems-oriented approach to an adverse event in healthcare.
MBChB 401: Anaesthesiology
 Applied Science for Medicine
1Summarise the major concepts in anaesthesia in the care of unconscious or seriously ill patients, including:
 •  changes to the airway in the unconscious patient;
 •  changes in the physiology of the cardiovascular, respiratory and nervous systems associated with loss of consciousness or induction of anaesthesia;
 •  initial steps in managing an unconscious patient;
 •  patient factors which influence anaesthesia risks and management options;
MBChB 401: Emergency Medicine
 Applied Science for Medicine
1Apply key basic science principles to the evaluation of patients presenting acutely in emergency medicine.
 Clinical and Communication Skills
3 •  Apply management algorithms for the resuscitation of a patient in cardiac arrest;
 •  Prepare a basic management plan for a poisoned patient;
 •  Prepare a basic management plan for all the patients you see.
MBChB 401: General Practice
 Applied Science for Medicine
1Apply key basic science, behavioural and social science principles to the evaluation of patients presenting with problems in primary care.
 Clinical and Communication Skills
2 •  Recognise key warning signs of serious illness in patients treated in primary care;
 •  Demonstrate skills for dealing with uncertainty (in a low prevalence environment) in clinical diagnosis in general practice;
 •  Use an evidence-based approach to diagnosis formulation;
3 •  Summarise the roles, responsibilities and linkages of those contributing to a primary health care team.
 Population Health
7Appraise the role of general practice within the wider health care network.
 •  Outline the New Zealand Health Strategy;
MBChB 401: Musculoskeletal
 Applied Science for Medicine
1Apply knowledge of basic anatomy and physiology of the musculoskeletal system to the management of patients with musculoskeletal problems.
 •  Summarise the anatomy and physiology of joints, tendons and related structures;
 •  Outline the interrelationships with other structures, including nerves and muscles.
2 •  Distinguish between inflammation and infection using macroscopic, microscopic and molecular features;
 Clinical and Communication Skills
3Evaluate patients presenting with a range of common musculoskeletal problems.
 •  Elicit from patients presenting with a given problem, a relevant, logical and comprehensive history, including a functional history for patients with rheumatic diseases;
 •  Recognise clinical situations that require early expert care.
7Apply specific techniques and principles appropriately.
 •  Apply simple casts;
 •  Outline the principles of management of patients in casts;
 •  Explain how intra-articular and soft tissue steroid injections are administered.
 Population Health
10Predict the likely future impact of musculoskeletal disorders on the New Zealand health system.
 •  Outline the orthopaedic and rheumatologic disorders that significantly contribute to morbidity in the New Zealand context;
 •  Analyse population and demographic trends to predict the future impact.
MBChB 401: General Surgery
 Applied Science for Medicine
1Apply knowledge of basic anatomy, physiology and pathology to the management of general surgical patients.
 •  Determine the causes and mechanisms of shock;
 •  Illustrate the physiology of normal fluid and electrolyte balance;
 •  Describe the nature of intravenous replacement fluids;
 •  Summarise the causes and management of common abnormalities of water, sodium and potassium metabolism;
 •  Describe the nutritional and metabolic needs of the perioperative patient;
 •  Apply the pathophysiology of sepsis to the perioperative patient;
 •  Describe the methods available for the provision of post-operative analgesia;
 •  Describe the management of common general surgical presentations and diagnoses as outlined in your POGS
 Clinical and Communication Skills
5Recognise common postoperative complications.
 •  Summarise the essential vital signs and systems to be monitored;
 •  Analyse and interpret common changes in TPR charts.
MBChB 401: General Medicine
 Applied Science for Medicine
1Apply key basic science principles to the evaluation of patients presenting with a wide range of common general medical problems.
 •  Appraise the importance of basic anatomy, physiology and pathology knowledge to the management of medical patients;
 Clinical and Communication Skills
2Evaluate medical patients presenting with a range of clinical problems.
 Population Health
8 •  Suggest evidence based public health approaches that would reduce the burden of medical diseases.
MBChB 401: Specialty Medicine
 Applied Science for Medicine
1Apply key basic science principles to the evaluation of patients presenting with a selected range of specialty medical problems.
 •  Appraise the importance of basic anatomy, physiology and pathology knowledge to the management of patients in specialty medicine;
 Clinical and Communication Skills
2Evaluate patients presenting with medical problems of the selected specialty.
MBChB 401: Geriatrics
 Applied Science for Medicine
1Apply key basic science principles to the evaluation of patients presenting with common conditions in older people.
 Clinical and Communication Skills
3 •  Apply best available evidence to solve clinical problems;
 Population Health
8Suggest evidence- based population health approaches that would reduce the burden of medical diseases in older people.
MBChB 401: Formal Learning Yr 4
 Clinical Pharmacology
 •  Develop, through study and application of pharmacological principles, a framework of knowledge that forms the basis for the safe and effective use of medicines in clinical practice.
 •  Demonstrate foundation skills for safe and effective prescribing.
 Pneumonia
 •  Identify the clinical features used to diagnose pneumonia and decide on the most appropriate treatment.
 Cardiovascular
 •  Explain how to detect and differentiate common heart valve diseases and aortic diseases.
 Blood Cancer
 •  Summarise the pathology of different blood cancers including the stage of development and cell type that is abnormal
 Neurology
 •  Explain the scientific characteristics, the parts of the nervous system affected and the pathological processes leading to the formation of common neurological conditions.
 Endocrinology and Diabetes
 •  Apply key basic science principles to the evaluation of patients with common endocrinological diseases (metabolic bone, thyroid, adrenal, pituitary, diabetes).
 Orthopaedics
 •  Demonstrate a working knowledge of patello-femoral pain, patellar instability and other soft-tissue causes of knee pain.
 Dermatology
 •  Accurately describe common rashes and lesions and their distinguishing features.
 Gout Symposium
 •  Explain the key checkpoints in pathogenesis of gout
 •  Summarise the impact of gout on the patient, whanau and community
 Gastroenterology
 •  Apply scientific knowledge of physiology to common and clinically important diagnoses and explain the rationale for their management.
 •  Explain the impact of selected GI conditions on population health, the role of population screening in GI cancers and the importance of advocating for health promotion to reduce the risk of disease.
 Alcohol and Drugs
 •  Explain the importance of shifting from a binary to a continuum of risk perspective regarding addictive consumptions (alcohol, gambling, smoking, illicit drugs).
 •  Summarise the steps to differentiate low risk, risky, problematic and dependent drinking.
 Oncology
 •  Develop a useful scaffold of prior knowledge on which to build the recent research findings and advances in cancer care.
MBChB 401: Synchronous Learning Yr 4
 Clinical and Communication Skills
 •  Compare typical and atypical presentations for common and important medical and surgical conditions.
MBChB 501: General Practice
 Clinical and Communication Skills
2Evaluate and prepare appropriate management plans for patients with common and important problems in general practice environments.
 •  Recognise key warning signs of serious illness in patients treated in primary care;
 •  Demonstrate skills for dealing with uncertainty in clinical diagnosis in general practice;
 •  Use an evidence-based approach to diagnosis formulation;
MBChB 501: Obstetrics & Gynaecology
 Applied Science for Medicine
1Explain the progress and management of women in labour.
2Explain the correct and effective use of common methods of contraception, including Long Acting Reversible methods (LARCS).
 Clinical and Communication Skills
7Present evidence based knowledge in core topics of obstetrics and gynaecology to peers.
MBChB 501: Paediatrics
 Applied Science for Medicine
1 •  Apply knowledge of basic anatomy, physiology and pathology to the assessment management of newborn and paediatric patients.
 •  Use knowledge of growth and development in newborns, children and adolescents to interpret manifestations of disease.
 Clinical and Communication Skills
2 •  Recognise, giving reasons, patients with serious acute illness.
MBChB 501: Psychiatry
 Applied Science for Medicine
1 •  Integrate with clinical practice prior knowledge of the normal structure, function and development of the human body and mind at all stages of life, the factors that may disturb these, and the interactions between body and mind.
 •  Apply scientific principles, research methodologies and evidence to improve practice and the mental health of individuals and communities.
 Population Health
11 •  Identify major threats to mental health and critique trends in healthcare delivery in New Zealand and internationally.
12 •  Apply the principles of mental health promotion, population screening and disease management involving individuals and populations to a range of healthcare settings.
MBChB 501: Specialty Surgery
 Clinical and Communication Skills
2Evaluate patients presenting with surgical problems of the selected specialty.
 •  Elicit from patients presenting with a given problem, a relevant, logical and comprehensive history;
 •  Perform an organised and professional examination of relevant organ systems;
MBChB 501: Formal Learning Yr 5
 Toxicology
 •  Explain the major toxicological antidotes
 Transfusion Essentials
 •  Discuss the diagnosis and management of iron deficiency anaemia in the preoperative patient and the value of intravenous iron in this context
 •  Discuss the decision to transfuse red cells in the stable post-operative patient versus transfusion in trauma/massive bleeding events
 Prescription Drug Abuse
 •  Explain the addictive potential of minor tranquilisers, particularly benzodiazepines
 Immunology: Venoms to Vasculitis
 •  Summarise the different types of hypersensitivity reactions and how these present clinically
 •  Explain the general approach to diagnosis of hypersensitivity related disease and apply to future clinical practice
 •  Apply the pathology and presentation of vasculitis and connective tissue disease to clinical cases
 •  Describe the principles of immune deficiency and common presentations
 Dilemmas in Palliative Medicine
 •  Improve prescribing practice using opioids, syringe driver medication and also converting oral medications to parenteral and practice
 Optimised Patient
 •  Apply knowledge of pathology and pathophysiology to anticipate the likely significance of patient comorbidities to anaesthesia and surgery.
 Clinical Pharmacology
 •  Develop, through study and application of pharmacological principles, a framework of knowledge that forms the basis for the safe and effective use of medicines in clinical practice
MBChB 551: General Medicine
 Applied Science for Medicine
 •  Key basic and clinical science principles are revised and applied to the management of patients presenting with a range of common acute and chronic medical conditions.
 •  Relevant anatomy, physiology and pathophysiology are revised for the presentation, diagnosis and management of common and important clinical conditions as outlined in the clinical scenarios.
 •  Application of pharmacologic principles is demonstrated in disease management and safe prescribing practice.
MBChB 551: Obstetrics and Gynaecology
 Clinical and Communication Skills
 •  Special emphasis on the importance of the diagnosis and management of preeclampsia and ectopic pregnancy
 Applied Science for Medicine
 •  Normal mechanism for delivery and the principles of assisted instrumental and caesarean delivery.
MBChB 551: Paediatrics
 Personal and Professional Skills
 •  Key health issues for Māori children and adolescents are identified, and approaches explained to addressing the issues.
 Applied Science for Medicine
 •  Differences in therapeutics and prescribing between different ages and sizes are understood, safely prescribe and chart medication, fluids and enteral feeds for newborns, preschool and school aged children and adolescents.
MBChB 551: Psychiatry
 Applied Science for Medicine
 •  Review neuroscience from Phase 1 and Psychiatry from Year 5 and apply knowledge to clinical scenarios.
 •  Understand principles of basic medication, for common mental health disorders.
MBChB 551: General Surgery
 Clinical and Communication Skills
 •  Specific emphasis on blood loss, sepsis, fluid and electrolyte disturbances and postoperative pain relief.
 Personal and Professional Skills
 •  Familiarity with local hospital practices and procedures relevant to the practice of surgery is demonstrated.
 Population Health
 •  Consider the following from a community and population level: traffic safety for trauma, alcohol for trauma, obesity for multiple diseases.
MBChB 551: Emergency Medicine
 Clinical and Communication Skills
 •  Recognition and signs of an unstable patient and recommended action are applied.
 Applied Science for Medicine
 •  Physiology is applied to unstable patients in ED settings.
 •  The ABCD procotol is applied to all ED patients.
MBChB 551: Clinical Imaging
 Clinical and Communication Skills
 •  Processes for use and interpretation of imaging modalities in urban, regional and rural settings.
 Hauora Māori
 •  Strategies identified to overcome barriers to imaging procedures to improve Māori health outcomes.