Dear Mr Huggan,

 

I refer to your Official Information Act request for information
concerning teaching about sepsis. The University’s response follows:

 

 1. “what formal teaching, learning and assessment activities specifically
address the recognition, escalation and early management of sepsis in
adults, pregnant/post-natal women and children” across the
University’s undergraduate programmes.

 

This has been addressed by School/Department (and programme in the case of
the MBChB).

 

School of Medical Sciences:

 

o Non-clinical undergraduate courses in the School of Medical Sciences
do not address the recognition, escalation and early management of
sepsis in adults, pregnant/post-natal women and children.
o For Molecular Medicine and Pathology, sepsis is taught in MEDSCI
courses 203, 301, and 314 at a basic, non-clinical level in 1-2
lectures or labs per course, and is assessed by questions in
tests/exams or lab reports.
o Further, in MEDSCI 202 there is teaching about the recognition of the
clinical syndromes, the laboratory tests that may help in confirming a
diagnosis, and the treatment and prevention, of infection due to the
following organisms (which in varying proportions of patients may
cause sepsis): Herpes simplex, Varicella zoster, Epstein Barr virus,
Hepatitis B virus, various AIDS illnesses including cerebral
toxoplasmosis and oro-oesophageal candidiasis, malaria, nosocomial
surgical wound infections, intravascular catheter associated
bacteraemia, urinary catheter associated sepsis, and bacterial
pneumonia. The content is taught in one-hour lectures and is assessed
by short answer exam questions

 

School of Population Health:

 

o Undergraduate courses in the School of Population Health do not
address the recognition, escalation and early management of sepsis in
adults, pregnant/post-natal women and children.

 

Bachelor of Health Sciences:

 

o Undergraduate courses in the Bachelor of Health Sciences do not
address the recognition, escalation and early management of sepsis in
adults, pregnant/post-natal women and children.

 

School of Pharmacy/Bachelor of Pharmacy

 

o For the Infectious Diseases module, sepsis is discussed in two
lectures, and several cases in ID consider sepsis in the context of
infection severity/management options – e.g. cellulitis, meningitis.
There is no specific reference to sepsis in the learning outcomes for
this module, although the antimicrobial stewardship lecture has the
following learning outcome which includes consideration of sepsis
“Discuss key attributes of both the infection and host that need to be
considered when selecting appropriate antimicrobial treatment". I note
that following is the reference used for antimicrobial guidelines in
the ID module and for any other infection cases throughout the
curriculum:
[1]https://www.adhb.health.nz/health-profes...
o For the Paediatrics module, septicaemia is discussed in one lecture as
part of a differential diagnosis, and sepsis is discussed in the
neonates lecture under the Learning Outcome “Explain the role of
antibiotics in the treatment of neonatal infections”
o Sepsis may be the subject of, or relevant to, assessment multi-choice
questions and short answer questions.

 

School of Nursing/Bachelor of Nursing:

 

o Sepsis is covered in the Nursing 201 Pathophysiology Course with two
hour long sessions and it is also covered in a one hour sepsis &
meningitis lecture within the microbiology module. Sepsis is assessed
within the micro test and/or as an MCQ or SAQ within the Nursing 201
exam.

 

Bachelor of Medicine, Bachelor of Surgery

The MBChB programme is taught across the School of Population Health, the
School of Medical Sciences and the School of Medicine. Sepsis and its
recognition and early management is taught in years 4,5 and 6 in lectures
as well as tutorial and bedside sessions in clinical attachments. It also
features regularly in written and clinical assessments such as OSCE’s.

 

By way of example, a search using ‘sepsis,  shows it features in 20 of the
clinical scenarios which provide the foundation of the MBChB curriculum
and assessment content.

The full 20 are:

o Acute abdominal pain
o Child with sore joints
o Diabetes in pregnancy
o Febrile infant
o Fracture
o Pancytopaenia
o Postop care
o Unwell neonate
o Acute kidney injury
o Acute presentation of diabetes
o Bowel obstruction
o Fever and a new murmur
o Infant or child with a murmur
o Infant with vomiting and diarrhoea
o Labour
o Late pregnancy complications
o Postpartum care
o T1 diabetes
o Fever and headache

 

During the Principles of Medicine Module in MBChB 2 students are
(re)introduced to infectious disease with specific focus on viral and
bacterial agents. The respiratory module also includes lectures about
COVID-19 and pneumonia. Specific to sepsis are lectures regarding: HIV,
COVID-19, influenza (including zoonotic and pandemic influenza),
Staphylococcus aureus, and Mycobacterium tuberculosis.

The main infectious disease teaching in phase 1 occurs during MBChB 3. The
Blood, Immunity and Infection (BI&I) module includes 19 lectures about
infectious disease topics; and 7 lectures about immunology, which has a
focus on host responses to infection. In addition, the module includes 4
microbiology labs which have a clinical focus on bacterial pathogens. All
of the infection topics are relevant for sepsis – but particularly
important are the common serious infectious disease topics: pneumonia,
skin and soft tissue infection, bacterial meningitis, infections of the
gastrointestinal tract, healthcare associated infections, and infections
of the urinary tract – each taught in a designated lecture. The lecture
regarding meningitis reviews the mechanisms of septic shock and
multi-organ failure.

 

All of the lectures in phase 1 use clinical scenarios to teach each topic
and are focussed towards the pathogenesis and epidemiology of each
condition with a smaller emphasis on management.

 

The lecture content is assessed in  final module exams – infectious
disease topics comprise at least half of the BI&I module exam. The BI&I
laboratory material is assessed via on-line assessments that also provide
feedback and further learning opportunities for students. Students with a
particular interest in infectious disease and sepsis can choose one of
many infectious disease topics for their critical review essay in MBChB 3.

 

“all curriculum documents and formal teaching modules that specifically
address sepsis in your medicine, nursing and pharmacy programmes".

“If learning about sepsis occurs within modules on individual infections
or syndromes, please specify learning outcomes within these modules that
address recognition and escalation of sepsis/critical illness.”

 

Your request for the University’s teaching materials on sepsis is refused
under section 9(2)(k) of the Official Information Act. Teaching materials
used by the University are the intellectual property of their respective
owners and it would be improper for the University to make these publicly
available.

 

The curriculum of the University’s MBChB, BNurs, and BPharm is set out in
two publicly available sources:

 

 1. The degree regulations as published in the University’s Calendar,
publicly available at [2]https://www.calendar.auckland.ac.nz/en.h...
or in pdf form at
[3]https://www.calendar.auckland.ac.nz/en/p...
 2. Course outlines for each course in the relevant programme, publicly
available at [4]https://courseoutline.auckland.ac.nz/dco

 

Your request for the University’s curricula is refused under section 18(d)
of the Official Information Act.

 

You have the right to make a complaint to an Ombudsman if you are
dissatisfied with this response.

 

If you would like to discuss the University’s teaching in relation to
recognising and managing sepsis please contact Professor Phillippa Poole,
Head of the School of Medicine [5][email address]      

 

 Yours sincerely,

Rebecca Ewert

Generals Counsel

 

From: Paul Huggan <[6][FOI #15523 email]>
Sent: Friday, 21 May 2021 8:16 AM
To: legal <[7][email address]>
Subject: Official Information request - Learning opportunities and
assessments addressing recognition and management of the sepsis syndrome

 

Dear University of Auckland,

Sepsis is a life-threatening organ dysfunction due to a dysregulated
immune response to infection. It is an important health issue in New
Zealand, with a higher incidence in Maaori and Pacific populations, and
with rates driven by underlying community morbidity.

In your undergraduate programmes, what formal teaching, learning and
assessment activities specifically address the recognition, escalation and
early management of sepsis in adults, pregnant/post-natal women and
children?

Please provide all curriculum documents and formal teaching modules that
specifically address sepsis in your medicine, nursing and pharmacy
programmes. If learning about sepsis occurs within modules on individual
infections or syndromes, please specify learning outcomes within these
modules that address recognition and escalation of sepsis/critical
illness.

Yours faithfully,

Paul Huggan
New Zealand Sepsis Trust

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