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Unit information: Clinical Element: Knee Surgery in 2020/21

Unit name Clinical Element: Knee Surgery
Unit code BRMSM0019
Credit points 20
Level of study M/7
Teaching block(s) Academic Year (weeks 1 - 52)
Unit director Professor. Andy Judge
Open unit status Not open

Candidates must be enrolled in a surgical training programme leading to a certificate of completion of training in orthopaedic surgery



School/department Bristol Medical School
Faculty Faculty of Health Sciences


The participation in four clinical units will allow candidates to focus on specific areas of orthopaedic surgery which are most relevant for their later careers.

The aims of the unit are to:

  1. Facilitate individualised learning by the co-creation of learning objectives and personal development plan by both candidate and Clinical Unit Tutor.
  2. Provide the opportunity for candidates to demonstrate their knowledge, understanding and application of advanced surgical theories and techniques in a subspecialty relevant to their personal career goals, under the guidance of senior clinicians in the field (the Clinical Unit Tutors).
  3. Preserve the clinical relevance of the programme

For each of the four clinical units, candidates will select a topic within a subspecialty to study in depth. This section of the programme is not aiming to add to the core clinical knowledge of the practising clinician but to enhance translational skills and knowledge to show added value beyond that offered by higher surgical training programmes. Candidates should expect to define the epidemiology, aetiology, clinical presentation, investigation, treatment options including a detailed understanding of relevant surgical techniques, the current state of the art, an appreciation of ongoing research and the direction of future development of an orthopaedic disease. The assessment of these learning aims is described below.

The co-created learning objectives for the Unit should be beyond the skills and knowledge needed for higher surgical examinations and outside the curriculum laid out by the Joint Committee on Surgical Training and should be outside those defined by the curriculum for the FRCS (Tr & Orth). The Clinical Unit Tutors will be required to agree that this is the case to show that the programme is adding to the academic skills and knowledge above what candidates would otherwise receive.

A list of subject topics with relevant key advanced texts will be provided by the Clinical Unit Tutors to assist candidates unable to identify a subject themselves. Multiple candidates could engage in similar topics, as the output generated should be independent and have a reflective element. Candidates are required to submit their topic title 4 weeks after commencing the clinical unit to the Clinical Unit Tutor for approval. This ensures that disengaged candidates are identified early and supported in developing their ideas and topic areas. Evidence of agreement of the topic area and title with the university tutor will ensure that they are engaged with the candidate.

Candidates will then have a period of 5 months in which to prepare their work. At the conclusion of the clinical element, a reflective piece of 1500 words will be recorded in their reflective diary. This piece will reflect on their clinical practice relevant to the selected topic, links with any previous Clinical Units undertaken, the Academic Skills unit and the Research Project. Candidates will also be encouraged to reflect on any extracurricular observations or experience.

On commencement of a clinical Unit, the following deadlines will apply:

End of week 4: Topic for study to be identified ad approved by the subspecialty lead.

Weeks 5- 24: Completion of study into the selected topic

Weeks 24-26: Completion of reflective piece

Annually: Case study and poster assessment day

Intended learning outcomes

To be awarded credit for this unit, candidates must show that they have:

Co-created individual specific learning objectives and goals within knee surgery.

Understood, evaluated and analysed the clinical and scientific principles of a specific topic within reconstructive or soft tissue knee surgery sufficient to explain the current and future diagnostic and therapeutic techniques to non subspecialist peers.

Exceeded the knowledge required about knee surgery required for post graduate trauma and orthopaedic surgical examinations.

Applied literature search and critical appraisal skills to find and appraise the published evidence regarding specific knee pathology showing higher level inquisitiveness, initiative and academic integrity.

Created and presented a scientific poster and an oral presentation to a professional audience to demonstrate a professional level of written and spoken communication of complex concepts and problems within reconstructive or soft tissue knee surgery.

Understood the role of and applied reflective assessment in the analysis and evaluation of learning new skills relevant to a clinician scientist.

Understand and employ time management strategies and adaptive capacity to deliver on self set deadlines.

Teaching details

Learning will primarily be self directed.

It is anticipated that learning methods will be, but not limited to:

Self directed reading of relevant texts

Studying relevant published literature

Discussions with senior local clinicians and subspecialty leads

Online learning: guidance regarding reflective writing made available on Blackboard

Assessment Details

The programme will include four 6 month clinical components, selected from eight available options. Although the structure of these is the same each time, the subspecialty studied for each will be different. Each of these will be allocated 20 credits. Two assessments will be made of each clinical unit: a reflective written piece of work and an extended oral case presentation or a poster presentation (the student can select the most appropriate method).

Candidates will have a period of 5 months during each of the components in which to prepare a 2000 word reflective piece of work documented in the reflective journal. This journal provides an aspect of programme level assessment for the programme by asking students to reflect on their learning and the different Units they are undertaking. This work should include a reflective on the aims laid out by the candidate in their personal development plan and should contain a 500 word section reflecting on the evidence of completion of the learning objectives. This piece will be supervised and reviewed by their university tutor and reviewed at the end of each 6 month placement. Learning for this work will be made available using existing resources within the Bristol Skills Framework (via Blackboard).

Secondly, candidates will be asked to deliver a 10 minute oral presentation OR a scientific poster of their topic of study at an annual examinations day (which may be held virtually depending on COVID restrictions). Over the two year programme, candidates will be expected to deliver two posters and two oral presentations. As a result students have a choice of the most appropriate assessment format for their material. The design and delivery of these will be mentored by the Clinical Unit Lead and University tutor. This will be the opportunity for candidates to use a specific case as a thread to explain the state of the art in a specific field, the techniques currently in use and areas of future development. Following the oral presentation, there will be 5 minutes of questioning during which the examiners will test the candidate on the breadth of their knowledge and understanding of related principles. Five minutes of questions will be directed at the candidates presenting posters during the presentation session in turn allowing an opportunity to present the work displayed in their poster. Both of these will be practiced in a formative setting every 6 months, where feedback on performance will be provided. This will ensure that candidates maintain momentum in producing their work.

Following the annual formal assessment, the examiners comments will be returned to the candidates in order to facilitate subsequent improvement. Each clinical unit represents 20 credits comprised of:

Reflective written piece of work: 5 credits (25%)

Extended case presentation OR poster presentation: 15 credits (75%)

Reading and References

Each clinical unit will benefit from a list of suggested texts and references provide by the Clinical Unit Lead. This list will direct candidates to the most appropriate reading material based on their topic of choice.