University of Technology Sydney

99630 Clinical Practice 1 (TCM)

Warning: The information on this page is indicative. The subject outline for a particular session, location and mode of offering is the authoritative source of all information about the subject for that offering. Required texts, recommended texts and references in particular are likely to change. Students will be provided with a subject outline once they enrol in the subject.

Subject handbook information prior to 2024 is available in the Archives.

UTS: Science: Life Sciences
Credit points: 12 cp
Result type: Grade and marks

Requisite(s): (91706 Neuroscience OR 91527 Pathophysiology and Pharmacology 3) AND 99647 Clinic Level 6 AND 91611 Clinical Practicum (Therapy and Diagnosis) AND 99584 Clinical Features of Disease AND 92227 Communication for Healthcare Professionals AND (91400 Human Anatomy and Physiology OR 91528 Health and Homeostasis) AND (91703 Physiological Systems OR 91529 Pathophysiology and Pharmacology 1)
Anti-requisite(s): 94680 Entering Professional Life (6cp) AND 94681 Entering Professional Life (8cp)

Note

To enter the Year 4 clinic, students must have successfully completed:

  • all subjects in Years 1–3
  • all clinical hours attached to clinic level subjects 1–6
  • all WIKIs attached to the clinical hours 1–6
  • a senior first aid certificate, current through to the Year 4 clinic period
  • a police check.

Description

In this multi-modular subject (clinical and academic), the student applies the full range of practitioner responsibilities (case interview with manual and digital recording; examinations such as pulse, tongue and channel palpation; formulation of a diagnosis and execution of the treatment plan) while under the guidance of a clinical supervisor. Clinical training is rostered and conducted on campus at the UTS Chinese Medicine Clinic, which provides low-cost services to the public. Limited external specialty practice in oncology is available at Concord Hospital for those interested and able to fulfil the NSW Health departmental requirements.

To enter the Year 4 clinic, students must have successfully completed:

  • all subjects in Years 1–3
  • all clinical hours attached to clinic level subjects 1–6
  • all WIKIs attached to the clinical subject hours 1–6
  • a senior first aid certificate, current through to the end of the Year 4 clinic period
  • a police check
  • disability declaration
  • Working With Children certification.

Subject learning objectives (SLOs)

Upon successful completion of this subject students should be able to:

1. Apply an understanding of the nature, practice and application of clinical Chinese Medicine within the UTS Chinese Medicine Clinic.
2. Apply analytical problem solving, critical thinking and an understanding/application of scientific methodology as it applies to treatment outcomes and evidence-based practice.
3. Apply a range of technical, personal, practical and professional skills in appropriate and ethical ways within the Chinese Medicine context (e.g. time management, personal organisation, teamwork, computerised data entry, herbal dispensary skills, data handling in accordance with legal and privacy laws).
4. Demonstrate quantitative and graphical literacy skills.
5. Analyse and critically revise the treatment process based on current and/or desired outcomes.
6. Engage in high level self-reflection.
7. Communicate in appropriate English Language (speaking and comprehension) and Academic English (reading and writing).
8. Demonstrate an ability to think and work creatively, be self-starting and understand the application of scientific skills to unfamiliar situations.

Contribution to the development of graduate attributes

1. Disciplinary knowledge and its appropriate application

This a capstone subject where emphasis is placed on the application of knowledge learnt throughout the course. The application is conducted within the UTS outpatient clinic in a format designed to mimic the realities of a graduate practitioner’s clinic, the main difference being that you still have the security of immediate access to supervisor consultation prior to treatment.

New knowledge is acquired through self directed research into the unfamiliar, unique or difficult clinical/disease presentations. In addition, the oral case history presentation adds a dimension of peer assessment to encourage you to be thorough in the investigation process in order to adequately answer peer questioning and impart new knowledge to the class as a whole.

Finally, the Learning Contract introduces a new method of learning designed to peak your interest in expansion of current knowledge while fostering a familiarity with modern research technologies of the web, library, etc.

2. An Inquiry-oriented approach
Your clinical experiences are geared towards encouraging you to think critically about your patients and the clinical situations they encounter. You are encouraged to apply your clinical reasoning skills and where necessary, seek additional sources of information to inform your decisions and processes.

The Learning Contract, as an integral part of the clinical experience and necessitates a focused inquiry-based approach to adopting research. You have the opportunity to develop skills and knowledge in a specialty area of particular interest This requirement involves an expansion of you knowledge beyond Chinese Medicine and into the biomedical aspects of the topic and latest treatment developments. Grading of the assignment focuses on the dialogic reflective aspects of the study, especially its outcomes and treatment approaches.

The seminar module reinforces these activities as your share your clinical experiences through reporting of case histories. This promotes peer learning as you aim to constructively critique each other’s clinical cases/activities and provide support through formal and informal feedback mechanisms.

3. Professional skills and their appropriate application
A number of professional skills are covered by this subject. You will have the opportunity to undertake a full range of clinical management duties including marketing, rostering, collegial discipline and daily management. You are to carry out the formal clinical management plan you developed in Clinic Level 6.

You also engage directly with members of the public. You are to carry out all the responsibilities of primary care practitioners in a professional and ethical manner, with due consideration of UTS policies and their legal responsibilities.

4. The ability to be a Lifelong Learner
As you enter the clinic, you will encounter new and sometimes challenging or unfamiliar disease conditions or patterns. As part of your clinical learning experiences, you must engage in active research to develop effective treatment strategies for your patients. This is undertaken in both informal activities such discussions with peers and clinical supervisors and formally written about in your learning contract. The case presentations are seminal to this process as you will formally assess other students and provide feedback on clinical activities. As these processes unfold and you encounter these new experiences, you develop a clear understanding of the need for continuing professional education in order to maintain the highest levels of professional practice and effective treatment outcomes.

5. Engagement with the needs of Society
The student internship clinic is the culmination of a series of clinical training subjects where you engage directly with members of the public under the supervision of qualified practitioners. Through this you will be made acutely aware of your professional and humanitarian responsibilities and your future role in the community.

6. Communication skills
You have the opportunity to develop a variety of high level communication skills in this subject.

As a student practitioner, you will engage with a variety of active and passive communication skills to effectively communicate with patients in order to decipher clinically valuable information, explain treatment procedures and disease processes both in Chinese Medicine and Western biomedical terms and generally engage with patients. You must effectively communicate the details of their cases to clinical supervisors and be able to discuss these at high levels of expertise. This develops your ability for communication with other health practitioners, for example for referral purposes, and lays the foundation if you may choose to engage more earnestly in profession-based or led activities.

The learning contract requires you to engage in dialogic reflection and document your learning experiences and processes. The case history presentation reinforces these standards, as you present and defend your clinical findings to your peers in a formal class situation.

7. Initiative and innovative ability
As you fully engage in the clinical process as an independent practitioner, you may come to realize the limitations of your knowledge and skills. Hence, you will have the opportunity to show initiative in adapting to new and challenging situations, and ensure that you deliver a valued service to your patients.

The learning contract serves as a foundation for the development of cognitive, analytical and research skills for those that may wish to engage in postgraduate studies. It requires you to independently identify and develop areas of knowledge and expertise relevant to the practice of Chinese Medicine. These areas of specialty knowledge can be later expanded upon in professional practice or further academic studies. They often form the basis of future postgraduate research programs and clinical trials.

Teaching and learning strategies

The subject is delivered through (1) practical, “hands-on” acupuncture and herbal clinics, (2) an analytical oral and written case history presentation requiring multimedia skills, professional terminology, appropriate English language, and (3) a negotiated practical and written Learning Contract project requiring design, outcome measurements, reflection and Academic English skills.

UTSOnline is used for:

  • the subject outline
  • publishing the current year’s Clinic Management Plan
  • additional supplementary information to support the assessment tasks
  • clinic and presentation rosters
  • posting of marking criteria
  • Turnitin (plagiarism detection software) submission
  • inter-student discussion boar
  • announcement

Pre-clinical and class preparation is conducted during the Orientation Week through a combination of face-to-face briefings with the clinic managers and assistants, and online review of the subject’s activities, assessments and marking criteria.

NOTE: Pre- clinical and class preparation begins in the previous semester’s Clinic Level 6 subject where the Learning Contract topic is chosen and pre-structured; the clinical attendance roster is developed for a pre-teaching session commencement (February) and the class Clinic Management Plan is constructed and finalised for online publication.

Feedback is tutor, peer and clinical supervisor based, formatted as interactive in-class oral and written critique, and a written competency based clinical assessment.

Collaborative group work is utilised within the clinical setting where, students are expected to assist each other with the daily management of the clinic. Within this setting an appreciation of the tolerance of uncertainty is developed.

Pre-census date feedback is provided during the Orientation Day Q & A session where open discussion provides the opportunity to ask how to manage conflict between rostered clinical attendance and personal commitments. There will also be a number of class presentations which will have been provided in-class feedback to demonstrate the format of the face-to-face class. Finally, an individual half hour face-to-face Learning Contract review with detailed feedback will have been completed by the census date.

1. Clinic Module
Although you will be expected to take full responsibility for your clinical practice, you must refer to the clinic manager for pre-treatment approvals before any therapeutic action is undertaken. Unless gross errors of judgment are involved, major changes are not generally made to the treatment plan.

You are to meet the following treatment quotas:

  • Acupuncture treatments: between 85 and 115 treatments (equivalent to 253 hours)
  • Herbal treatments: between 30 and 60 treatments and 100 herbal hours
  • Total minimum number of patient treatments must equal 115 and a minimum of 100 herbal hours.
  • You are to keep a log book of treatments and enter your patient data into the computerised clinic database. Cross referencing of your logbook with the database is carried out towards the end of each teaching session, and you are to ensure that the two sets of records match i.e. that data on claimed treatments match the computer database.

Business Management, teamwork, tolerance, time management, are developed within the clinical module, as you are responsible for all aspects of managing, marketing and running the internship clinic. A Clinical Management Plan is constructed as part of the Clinic Level 6 subject in negotiation with the subject coordinator. This plan forms the basis for all procedural and clinical duties, notwithstanding any Faculty or University procedures that may supersede any processes documented in the students’ Clinical Management Plan.

You are to act professionally and ethically at all times.

Your duties involve but may not be limited to:

  • setting up and care of all the essential acupuncture and herbal equipment required for the practice of acupuncture and dispensing of herbal medicines,
  • all aseptic techniques and the requirements of proper patient care being carried out, either personally or by a supervised student assistant in compliance with the NSW skin penetration regulations and UTS Clinical Procedures Manual,
  • diagnosis, establishment of therapeutic objectives, treatment protocols and herbal prescriptions, giving of instructions and advice to the patient relating to CM therapy,
  • accurate and legible recording of all patient details, diagnostic conclusions and treatment programs, including update of manual and electronic patient records in compliance with state and federal privacy regulations,
  • recording of adverse events,
  • management of the outpatient clinics and referral of patients as required.

You must not undertake any treatment protocols without FIRST having your protocol approved and SIGNED OFF by the supervisor on duty. This is a legal requirement for student treatments.

You must not self-prescribe herbs. All herbal products must be dispensed after a proper consultation and with the sign-off of the supervisor.

2. Competency Assessment
You will need to make an appointment with the clinical manager in the acupuncture and herbal clinics. At the appointed time, you will be required to perform an acupuncture/herbal treatment on a patient under the observation of the clinical manager. The observation process may include the interview, diagnosis and treatment/prescription phases or as the clinical manager otherwise directs.

Portions of the herbal dispensing assessment may be administered by the clinic manager’s assistant.

You will need to obtain the consent of the patient and inform them that a clinic manager will be observing the treatment process, inclusive of gathering case history information. You can undertake this assessment at any time during the first semester. One such assessment must be completed in each session by week 12.

3. Seminar Module
2 hours per week, number of weeks to be determined by number of presenters.

You will present a case history. The same case must not be used for both the presentation and Learning Contract. A three way assessment process will be conducted. You will orally present and analyse a minimum of two consecutive treatments on the same patient for the purpose of comparison between the treatments provided vs. a potential course of action dictated by retrospective critical reasoning. This will encourage you to reflection on your level of knowledge, shortfalls and attitudes that may impact “best practice”. Your peer group will provide immediate classroom feedback and “brainstorming” of the case through questions and suggestions, both orally and as a written commentary to be given to each presenter.

4. Learning Contract (LC)
The Learning Contract is a structured, yet negotiated task where you will set your own learning goals and objectives in relation to an area of clinical specialisation. You will then undertake your own work to achieved these objectives through a series of literature reviews (professional and clinical evidence based research), dialogic reflective reports, and graphical and numerical evidence, and then provide evidence of how you have met your goals and objectives. You will begin preparation for the LC in consultation with the subject coordinator in Clinic Level 6 (99647), during Spring session of year 3.

The LC is revised at the outset of your year 4 clinical experience and if necessary re-negotiated with your subject coordinator. While the LC follows defined guidelines, it offers a degree of flexibility to choose the learning pathway most appropriate to your needs. Development of the LC and its related negotiated tasks will, of themselves, constitute a learning exercise in that you are expected to identify your knowledge shortfalls, identify the best way to correct them, and identify/construct/implement measurable outcome measurements appropriate to your topic.

Content (topics)

There are no formal lectures in this subject. Rather, students undertake tasks based on their clinical experiences, underpinned by their previous years studies. The content of the case presentations and the learning contract are determined by the student.

Seminar Program: To be advised and subject to change

Assessment

Assessment task 1: Supervised Clinical Practice and competency assessment

Intent:

This task addresses the following graduate attributes:

1. Disciplinary knowledge and its appropriate application
2. An inquiry-oriented approach
3. Professional skills and their appropriate application
4. The ability to be a Lifelong Learner
5. Engagement with the needs of Society
6. Communication skills
7. Initiative and innovative ability

Objective(s):

This assessment task addresses subject learning objective(s):

1, 2, 3 and 5

This assessment task contributes to the development of course intended learning outcome(s):

.0, .0, .0, .0, .0, .0 and .0

Weight: 10%
Length:

Quota accruals: ongoing until the numbers are met as described under "Tasks".

Competency assessments:

Herbal consultation assessment: Will involve ongoing observation and finalised by supervisors once sufficient observation has been acheived to address all the criteria.

Dispensary: 30 minutes: May be conducted any time but must be pre-arranged with Sheila. There will be one per subject

Acupuncture: Will involve ongoing observation and finalised by supervisors once sufficient observation has been acheived to address all the competency criteria. There will be one per clinical subject.

Criteria:

1. Component One (CLINICAL QUOTAS)

  • Quotas /hours: described under the TASK section
  • Completion: must be completed within the published operating times of the 4th year clinic. The normal accrual period for an AUTUMN subject runs from February to June. The July to December clinic quotas normally apply to the SPRING subject. The UTS intern clinic operates throughout the year; closed only for public holidays.
  • Clinic Locations: currently one location for authorized clinic hour accrual – UTS Chinese Medicine Clinic: for both acupuncture and herbal hours/quotas
  • Attendance criteria: clinics are rostered; students must be in attendance as scheduled unless otherwise authorized and on time.

2. Component Two (CLINICAL COMPETENCY ASSESSMENT)

  • Criteria: published in UTSOnline.

  • Acupuncture: assesses cumulative observation over the subject’s session; designated Formative if it is the first assessment conducted in the year 4 clinical internship; Summative/Exit if administered in the final session of the clinical internship.

  • Herbal: also cumulative; designation as for acupuncture; includes an additional rostered assessment in the dispensary.

  • Attendance criteria: both clinic locations are rostered; students must be in attendance as scheduled unless otherwise authorized and on time.

  • Logbook hours/quotas: must be entered in the 4th year logbook; each shift must be signed off by the supervising practitioner at the time of completion.

  • Logbook storage: UTS Clinic- the logbooks must remain in the supervisor’s office at the end of each shift. Do not take home.

  • Audit: A “logbook/ database/patient record” audit may be conducted where there is a discrepancy between logbook entry and the clinic data base.

  • Failure to complete the written assessment within the teaching session of the subject may be deemed as having failed the task risking an award of an X grade Fail.

Assessment task 2: Case Presentation

Intent:

This task addresses the following graduate attributes:

1. Disciplinary knowledge and its appropriate application
2. An inquiry-oriented approach
3. Professional skills and their appropriate application
4. The ability to be a Lifelong Learner
5. Engagement with the needs of Society
6. Communication skills
7. Initiative and innovative ability

Objective(s):

This assessment task addresses subject learning objective(s):

1, 2, 5, 6 and 7

This assessment task contributes to the development of course intended learning outcome(s):

.0, .0, .0, .0, .0, .0 and .0

Weight: 40%
Length:

Oral presentations: run for 15 minutes with an additional 5-10 minute Q&A time. All presentations are timed.

Written: no maximum; needs to be sufficient to address all the criteria listed in the grade sheet

Peer assessment: in addition to the grade sheet, a 250 word justification of marks awarded must accopany the grade sheet.

Criteria:

The purpose of this assessment is to address the Graduate Attributes (GA) listed under the Intent section. The clinical experience which forms the basis for the presentation assessment addresses virtually all seven Graduate Attributes. This assessment further reinforces professional skills, communication, inquiry-orientated approach and disciplinary knowledge.

The assessment has two formats: oral and written.

1. Oral:

  • Rostered (students may swap but provide subject coordinator 24 hour notice)

  • Report on 2-3 consecutive treatments (same patient)

  • Case must be current to the subject’s enrolment session (earlier cases or treatments that were provided by other students:not acceptable and may attract a fail)

  • Case must be extracted from treatment provided within one of the two authorized student clinics (other outside treatments will be refused and may attract a fail)

  • Use power point and demonstrate public speaking skills

  • 15 minutes presentation (timed) plus 5 minutes interactive peer Q & A

2. Written:

  • Proof read; use Academic English and APA style referencing – mandatory and graded within the criteria sheet

  • Two full copies w/ overheads (4 per page); one should be in a clear plastic sleeve (1 for tutor; 1 for peer marking)

  • Double sided print

  • Bound with numbered pages (eg. 2/10)

  • Font size: 12

  • Comment margin: right side (3 cm)

  • TURNITIN: mandatory with a copy of the "Originality" report attached

  • Recycled assignments: no former assignment from any subject allowed to be integrated in part or whole; Learning Contract case cannot be used

  • Cover sheet: customized to the assignment; download from the subject’s UTSOnline

  • Originality declaration: (part of cover sheet); signed and attached to the assignment

Further details regarding task requirements can be found on UTSOnline

sessed on a number of levels by both peers and staff and cover general areas such as content, delivery and evidence of critical thought and reflection.

Assessment task 3: Learning Contract

Intent:

This task addresses the following graduate attributes:

1. Disciplinary knowledge and its appropriate application
2. An inquiry-oriented approach
3. Professional skills and their appropriate application
4. The ability to be a Lifelong Learner
5. Engagement with the needs of Society
6. Communication skills
7. Initiative and innovative ability

Objective(s):

This assessment task addresses subject learning objective(s):

1, 2, 4, 5, 6, 7 and 8

This assessment task contributes to the development of course intended learning outcome(s):

.0, .0, .0, .0, .0, .0 and .0

Weight: 50%
Length:
  • Minimum of 50 bound pages exclusive of Table of Contents, bibliography and Appendices
  • The Final summative report section: minimum 500 words; no maximum
Criteria:
  • The purpose of this assessment is to provide a novel learning experience which is flexible and negotiated between the student and subject coordinator. It is intended to expand on the basic design and application of informal research with a clinical focus.
  • Criteria grade sheet: download from UTSOnline
  • Ref the “TASK” field for further information
  • Minimum of 2 pieces of literature research with 300-word minimum each, formatted in an annotated bibliography style; preferably one of the two required be evidence-based if appropriate
  • Minimum 500-word analysis of the measurement outcomes, discussion of fulfilment of the original learning objectives, discussion of any oversights and/or possible improvement in the design and execution of the project
  • Proof read
  • Academic English and Harvard (UTS) style referencing

Minimum requirements

All treatment and clinical attendance requirements must be met to pass this subject.

In order to pass this subject:

  • Students are expected to attend all oral presentations.
  • A minimum mark of 40% (20/50) must be achieved in the Learning Contract.
  • Students must complete a competency assessment.
  • All treatment quotas must be met.
  • All patient records must be complete and entered in to the patient database.

An X grade (fail), regardless of the final mark, will be awarded where the minimum criteria are not met.

In relation to clinical placements and practice workshops, students are expected to:

  • behave in an ethical manner;
  • observe University clinical policies and procedures;
  • observe relevant State and Federal regulations;
  • maintain a duty of care to patients and fellow students, and
  • demonstrate an acceptable level of professional conduct.

Where a student fails to comply to minimum standards or a reasonable direction from an officer of the University, the student may be asked to cease attendance at clinic or practical workshops and/or be awarded an X grade (fail).

Clinic attendance is based upon a treatment quota system. Once a treatment quota is reached, the allotted hours are deemed to be completed. Students will then be asked to no longer attend clinics. You will not be permitted to continue to treat patients once you have finished your quota without the express permission of the 4th year Clinical Program Co-ordinator.

Attendance at clinic should be co-ordinated with the student roster managers.

X Grade: X > 45 Unsatisfactory performance in an assessment item for which a pass is compulsory. This grade indicates to the Results Ratification Committee those students who have failed a subject overall with a mark of 45 or more, and are ineligible to pass because of their failure in a compulsory assessment item. There is no formal upper limit for this grade. An X grade may be awarded by the subject coordinator for a failure to complete any of the threshold tasks within the specified times or, in consultation with the clinical manager, in relation to a students competency within clinical placements and or practical classes.

Q grades may be awarded where outstanding clinic hours remain.

Recommended texts

UTS College of Traditional Chinese Medicine, Clinical Policy and Procedures Manual, Sydney: UTS (current).

New South Wales Department of Health (1990) Skin Penetration Regulations.

Chinese Medicine Board website

Other resources

Baldry, P., 2005, Acupuncture, Trigger Points and Musculoskeletal Pain, Elsevier Churchill Livingstone, Edinburgh

Chirali, I. Z., 1999, Traditional Chinese Medicine Cupping Therapy, Churchill Livingstone, Edinburgh

Clavey, S., 2008, Fluid Physiology and Pathology in Traditional Chinese Medicine, 2nd edn, Churchill Livingstone, London

Deadman,P, Al-Khafaji,M, Baker,K., 2001, A Manual of Acupuncture, Journal of Chinese Medicine Publications, East Sussex

Deng, T., 1999, Practical Diagnosis in Traditional Chinese Medicine, Churchill Livingstone, Edinburgh

Denmei, S, 1990, Japanese Classical Acupuncture Introduction to Meridian Therapy, trans S. Brown, Eastland Press, Seattle

Liu, W. P. , 1996, Therapeutics of Acupuncture and Moxibustion, Medicine and Health Publishing Co, Hong Kong

Maciocia, G., 1987, Tongue Diagnosis in Chinese Medicine, Eastland Press, Seattle

Maciocia, G., 1994, The Practice of Chinese Medicine, Churchill Livingstone, Edinburgh

Maciocia, G., 1998, Obstetrics & Gynocology in Chinese Medicine, Churchill Livistone, New York

Mayor, D., 2007, Electroacupuncture A practical manual and resource, 3rd edn, Elsevier Churchill Livingstone, Edinburgh

Neeb, G, 2007, Blood Stasis, China's classical concept in modern medicine, Churchill Livingstone, Edinburgh

Pirog, J., 1996, The Practical Application of Meridian Style Acupuncture, Pacific View Press, Berkley

Rogers, C., Rogers, C., 2012, Point Location and Point Dynamics Manual, Australian College of Acupuncturists Ltd, Sydney

Scheid, V.,2007, Currents of Tradition in Chinese medicine 1626-2006, Eastland Press Inc, Seattle

Scott, Julian, 2005, Acupuncture for the Eyes, Eastland Press, Seattle

Wang, J., Robertson, J. 2008, Applied Channel Theory in Chinese Medicine, Eastland Press, Boulder

Xu, X.,1998, Complete External Therapies of Chinese Drugs, Foreign Languages Press, Beijing

Zhu, M., 1992, Zhu's Scalp Acupuncture, 8 Dragons Publishing, Hong Kong

http://www.chinesemedicineboard.gov.au

Additional material as advised