96036 Neurological Ocular Disorders
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Subject handbook information prior to 2024 is available in the Archives.
Credit points: 6 cp
Result type: Grade and marks
Requisite(s): 96032 Binocular Vision and Ocular Motility 2
There are course requisites for this subject. See access conditions.
Description
Through problem-based learning, complex neuro-ophthalmic conditions are studied and medical record analysis, diagnostic testing and management strategies are discussed. Knowledge of orthoptic and ophthalmic examination principles and ocular function is advanced to the adaptation of test and management procedures in the presence of cognitive, physical and communication defects associated with brain injury, lesion and stroke. In a patient-focused approach, the impact of disease processes on general and ocular function, processes of recovery and adaption, and the integrated management of people with neurological conditions by the multidisciplinary healthcare team are studied. Relevant scholarly evidence is applied to inform orthoptic practice in neurology. Topics include: neuro-ophthalmic investigation, stroke, head injury, headache, visual field investigation and analysis; supra-nuclear, nuclear, inter-nuclear and infra-nuclear defects; and therapeutic approaches for neurological conditions.
Subject learning objectives (SLOs)
| 36.1. | Apply knowledge of neuro-anatomy and physiology and the pathways which control ocular and facial movement to the analysis of signs and symptoms related to neurological disorders including, stroke and acquired brain injury. |
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| 36.5. | Demonstrate an awareness of the differing roles within the multidisciplinary neurological team and articulate the contribution of the orthoptist to the effective management of patients with neurological conditions in conjunction with other health professionals. |
| 36.4. | Demonstrate effective and accurate verbal and written communication and further modify their communication approach in the context of a patient’s capacity and neurological deficit to ensure appropriate, respectful and ethical patient care. |
| 36.2. | Integrate theoretical knowledge of ocular motility, strabismus and ocular pathology with current evidence and sound clinical reasoning and apply this to the design of appropriate investigation and interdisciplinary management plans in patients with neuro-ophthalmic conditions. |
| 36.3. | Use advanced orthoptic and ophthalmic skills for the investigation and management of patients with neurological conditions. |
Course intended learning outcomes (CILOs)
The learning outcomes for this subject are as follows:
- Demonstrate professional behaviour and expertise in the delivery of safe, competent and responsible practice for the benefit and care of patients and the wider community. (.01)
- Reflect on knowledge, attitudes and skills acquired for the evaluation and integration of emerging evidence into practice, promoting the growth of personal and professional learning and the education of others. (.02)
- Analyse and synthesise knowledge of health sciences concepts and theory, and apply skills of scientific research and clinical reasoning to support decision-making in orthoptic practice. (.03)
- Engage in leadership and collaboration for the development of patient-focused clinical teams to ensure the integration of effective health care. (.04)
- Be an advocate for their patient, demonstrating sound, ethical, compassionate and respectful patient-focused care while acknowledging responsibility for personal health and wellbeing. (.05)
- Effectively and accurately communicate to patients, their families, carers and members of the healthcare team and contributing to the wider role of health education and its promotion, acknowledging and adapting communication to address cultural and linguistic diversity. (.06)
- Demonstrate knowledge of health systems and concerns in national and global communities, with awareness of the social and cultural context of their practice reflected in a consultative approach to the formulation and implementation of management plans that meet the diverse needs of individuals and communities. (.07)
- Demonstrate respect and value for diverse ways of knowing, being and doing, in particular recognising the diversity of Indigenous Australians while critically reflecting upon the impact of ongoing colonisation and its pervasive discourse on their health and wellbeing, and integrating this knowledge into practice. (.08)
- Represent the role of the orthoptist in multidisciplinary environments and through self-awareness and acknowledgement of the contribution of other health practitioners, support an interdisciplinary approach to attain the best outcomes for patients. (.09)
Contribution to the development of graduate attributes
This subject contributes to the development of the following graduate attributes:
- Lifelong learning
- Professional capacity
- Global citizenship
- Cultural Competence
Teaching and learning strategies
Preparation for Learning: Students will be provided with the details of preparation activities each week through the subject’s Canvas site. Activities are designed to help students prepare for their learning in lectures and workshops by engaging them with textbook, journal and other readings, videos, online resources, quizzes and short answer questions and group discussion. In addition, clinical practical classes have pre-practical reading and questions attached, which are expected to be completed prior to attending these classes to ensure maximal time can be spent on hands-on practice.
Active Workshops: Workshops throughout the session are opportunities for active class discussion and collaborative thinking around topic areas and clinical problem-based learning scenarios. Workshops require students to engage and participate in the analysis of case presentations, quizzes and trivia, class discussion and debate and other active and collaborative learning methods.
Case-based Learning: Case-based learning is a form of problem-based learning (PBL) and a key learning strategy used in workshops throughout the semester. Authentic patient clinical cases are analysed individually and in small (POD) groups. Through this students develop skill in clinical reasoning and practice the application of theoretical knowledge gained in lectures and practical classes to differentially diagnose and develop appropriate plans for the investigation and management of patients with a variety of ocular conditions. Clinical reasoning skills practised in workshops are utilised in the case study assessments in this subject.
Research-integrated Learning: Taking an evidence-based approach to the investigation and management of patient cases is essential for effective patient care and an important skill for Orthoptic students to develop. Current research is integrated into content provided in lectures and pre-work and students are provided opportunities in workshop classes and through assessment to read, discuss and utilise current research in ophthalmology and orthoptics in the context of evidence-based patient care. Evidence-based practice skills will be utilised to synthesise research findings and theoretical knowledge and create appropriate multidisciplinary management plans in the case study assessments.
Collaborative Learning: As health professionals, teamwork is an essential skill to ensure patients are managed appropriately within interdisciplinary teams of health professionals. Teamwork skills are developed through collaboration with peers in active lectures and workshops, conducted in collaborative POD classrooms, as well as, when performing clinical skills in practical classes.
Reflective Learning: Students are encouraged to critically reflect on their learning throughout the subject to identify areas where they may improve their performance and to assist in the development of lifelong learning skills. Specific activities where reflective learning is encouraged are; self-evaluation of clinical skill performance in practical classes against OSCE marking criteria and skill achievement checklists.
Practice-based Learning: Clinical practical classes are conducted in small groups (max. 12 students). These provide students with an opportunity to learn and develop competency in clinical skills relevant to orthoptic practice. These sessions are entirely practice-based and following a short demonstration of the skill, students are closely supervised and provided instruction and feedback, as they participate in hands-on practice of skills for neurological assessment and management of visual outcomes of neurological disorders.
Simulated Clinical Experiences: Clinical practical classes are conducted in our dedicated teaching clinic rooms and provide students with access to a simulated clinical environment including, key technology used in professional orthoptic practice. Students participate in role play and simulation of various ocular conditions using prisms and other orthoptic equipment. Students are additionally shown patient videos to demonstrate conditions and test responses in lectures, workshops and practical classes.
Self-directed Practice: Clinical practical classes provide students with supervised practice of clinical skills, however, to attain a sufficient level of competency in clinical skills, self-directed practice outside of class time is required. As a general guide, students are expected to spend approximately 1 hour of self-directed practice in the orthoptic dedicated teaching clinics per subject. This is important preparation for clinical placement and your OSCE exams.
Ongoing Feedback: In-class verbal feedback is an important teaching and learning strategy employed throughout the subject. Students are provided with immediate feedback relating to the performance of clinical skills in clinical practical classes and relating to clinical reasoning and understanding of key concepts by staff facilitating workshops. Opportunities for verbal formative feedback on assignments are given prior to final submission and detailed summative feedback following submission. Prior to OSCE examinations, Mock OSCEs will be held to provide students with formative feedback on clinical skills.
Content (topics)
Neurological Ocular Disorders is part of the binocular vision and ocular motility stream of the Masters of Orthoptics course. However, content from all preceding subjects; Binocular Vision and Ocular Motility 1 and 2 and Ocular Pathology 1 and 2 in particular, are integrated and furthered in Neurological Ocular Disorders in the context of Neurological patients and conditions. Foundational knowledge of neuroanatomy and physiology acquired in 96027 Eye, Visual Systems is reiterated, and the impact of pathology and trauma to these structures on visual function is addressed. In addition to theoretical knowledge of neurological conditions, this subject prepares students for the assessment of these conditions by refining orthoptic clinical skills introduced in Binocular Vision and Ocular Motility 1 and 2 as well as, ophthalmic investigative procedures introduced in Ocular Pathology 1 and 2 and the introduction of more advanced procedures. Emphasis is also placed on the development of clinical reasoning in the analysis of patient examination data and the creation of evidence-based, multidisciplinary management plans. This subject is closely aligned with concurrently taught subjects; 96035 Research Project 1 and 96037 Therapy, Management and Rehabilitation. Learning in this subject is further built on in subsequent semesters in 96040 Advanced Professional Practice.
Topics covered in this subject include; neuroanatomy with a focus on brainstem anatomy and pathways of the cranial nerves, ocular motor systems including the pathways for the generation of eye movements such as pursuits, saccades and vestibulo-ocular reflex, stroke, traumatic brain injury, inflammatory/infective and demyelinating conditions of the central nervous system, visual pathway and optic nerve disorders, pupil pathways and defects, headaches, ocular cranial nerve palsy (3rd, 4th and 6th cranial nerves), nystagmus, skew deviation, horizontal and vertical gaze palsies, intranuclear ophthalmoplegia, one and a half syndrome, Parinaud’s syndrome, double elevator palsy, progressive supranuclear palsy, the investigation and management of neuro-ophthalmic conditions.
Assessment
Assessment task 1: Build an Exam
| Intent: | This assessment task is designed to facilitate critical-thinking and revision around topic areas by asking students to create a multiple-choice answer questions and complete quizzes based on topics learnt throughout the semester. Constructing these questions and completing the quizzes will require students to develop a solid understanding of each topic content. |
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| Objective(s): | This task is aligned with the following subject learning objectives: 36.1, 36.2 and 36.4 This task is aligned with the following course learning outcomes: .01, .02 and .03 |
| Groupwork: | Individual |
| Weight: | 20% |
| Criteria: | Submitted questions will be assessed according to the following criteria:
Detailed assessment criteria provided in class and on Canvas. |
Assessment task 2: Case Assignments
| Intent: | The case study assignments reinforce and extend theoretical understanding of neurological conditions developed in lectures and workshops and allow students to practice and improve their clinical reasoning skills by combining clinical knowledge and research evidence in the analysis of patient information. Evidence-based practice skills are also developed in the context of the creation of multidisciplinary management plans. |
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| Objective(s): | This task is aligned with the following subject learning objectives: 36.1, 36.2, 36.4 and 36.5 This task is aligned with the following course learning outcomes: .01, .02, .03, .04, .05, .06, .07, .08 and .09 |
| Type: | Case study |
| Groupwork: | Individual |
| Weight: | 60% |
| Length: | 1500-2000 words |
| Criteria: | You will be assessed on your ability to:
Detailed assessment criteria provided in class and on Canvas. |
Assessment task 3: Goldmann OSCE (must-pass component)
| Intent: | An OSCE is an assessment format that enables students to demonstrate components of understanding, clinical and equipment skill, clinical reasoning and communication that are not readily assessed in a written format. These exams will allow the student to demonstrate knowledge they have gained across the subject through lectures, clinical practicals and through self-directed practice. |
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| Objective(s): | This task is aligned with the following subject learning objectives: 36.2, 36.3 and 36.4 This task is aligned with the following course learning outcomes: .01, .03 and .06 |
| Type: | Examination |
| Groupwork: | Individual |
| Weight: | 20% |
| Length: | 45 minutes |
| Criteria: | This exam aims to assess the student in a structure that best assesses their competency for participation in a future clinical working environment, such as clinical placements. As such, the primary level of competency must relate to the patient’s safety for all examinable procedures. Students must also demonstrate that they are able to effectively complete the set tasks within the given timeframe. At this stage of the course, emphasis will be given to good levels of patient instruction and communication, demonstration that tests are conducted in a safe and effective manner and that the findings of the clinical examination and the results recorded are accurate, so that appropriate conclusions can be drawn from findings. Prior to the exam students will be given the criteria for the examinable clinical skills. |
Minimum requirements
In order to pass this Subject, students are required to attend a minimum of 90% of lectures and workshops as well as 100% of clinical practicals. Lectures presented by guest lecturers will be compulsory to attend. Students must submit all assessment tasks and achieve a minimum of 50% of the subject’s total marks overall. The Objective Structured Clinical Examination (OSCE) is a compulsory component of assessment and students must achieve a minimum of 50% and perform all skills safely to pass the subject.
Required texts
Coursework Assessments Procedures
Graduate School of Health Policy, Guidelines and Procedures (login required)
Recommended texts
Students will be required to access journals through the UTS library and reference appropriate journal articles. Specific references may be indicated, if required via Canvas throughout semester by the coordinator or lecturers. In addition, the following texts may be of use:
Ansons, AM & Davis H, (2014) Diagnosis and Management of Ocular Motility Disorders 4th ed. Wiley-Blackwell
Rowe, FJ (2012) Clinical Orthoptics. John Wiley & Sons, Hoboken
von Noorden, GK (2002) Binocular vision and Ocular Motility, Theory and Management of Strabismus, Mosby
Kline, L. B., & Bajandas, F. J. (2008) Neuro-ophthalmology review manual. Slack Incorporated.
Wong, A. (2008). Eye movement disorders. Oxford University Press.