Saudi Interns Curriculum

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Saudi Interns Curriculum by Mind Map: Saudi Interns Curriculum

1. Design

1.1. Kern's 8-Step Curriculum Design

1.1.1. Step 1: Problems Identification & General Needs Assessment Identification & Characterization of the Health Care Problem Whom does it affect? What does it affect? What is the quantitative and qualitative importance of the effects? Analysis of the current approach What is currently being done by What personal & environmental factors affect the problem? Ideally, what should be done by the following? Health Care Professionals Medical Educators Society What are the key differences between the current and ideal approaches? (Problem Identification) Methods for Obtaining the Necessary Information Review of Available Information Use of Consultants & Experts Collection of New Information

1.1.2. Step 2: Needs Assessment of Targeted Learners Targeted learners Interns at their last rotation Beginning of PGY-1 Content Potentially Relevant Previous training and experiences relevant to the curriculum Already-planned training and experiences relevant to the curriculum Existing proficiencies Current performance Perceived deficiencies and learning needs Preferences and experiences regarding different learning strategies Characteristics of the learners' and the curriculum's environment Resources available to learners Methodology General considerations Choice of methods

1.1.3. Step 3: Goals & Specific Measurable Objectives General considerations Who will do how much (how well) of what by when? Use precise words Have the objectives reviewed by external reviewers Several cycles of writing objectives to reach manageable number of objectives General Goals Objectives Learners' Objectives Process Objectives Outcome Objectives

1.1.4. Step 4: Educational Strategies General guidelines Maintain congruence between objectives and methods Use multiple educational methods Choose educational methods that are feasible in terms of resources Curriculum Content (Syllabus) Explicit statement of learning objectives Schedule Written curricular materials Suggestions/resources for additional learning Educational Methods Reading Lecture Discussion Problem-solving exercises Programmed learning Learning projects Role models Demonstration Real-life experiences Simulated experiences Audio or video review of learner Behavioral/environmental interventions

1.1.5. Step 5: Implementation Procurement of Support Internal External Identification & Procurement of resources Funding Teaching Materials Physical Resources Personnel Time Facilities Funding/Costs Identification & address of barriers to implementation Financial & other resources (time) Competing demands People Develop administrative mechanisms to support the curriculum Administrative structure Communication Operations Introduction of the curriculum Pilot Phase-in Full implementation Refinement of the curriculum over successive cycles

1.1.6. Step 6: Evaluation & Feedback Tasks 1. Identify users 2. Identify uses 3. Identify resources 4. Identify evaluation questions 5. Identify evaluation designs 6. Choose measurement methods and construct instruments 7. Address ethical concerns 8. Collect data 9. Analyze data 10. Report results

1.1.7. Step 7: Curriculum Maintenance & Enhancement Dynamic nature of curricula Understanding one's curriculum The written or intended curriculum The environment/setting of the curriculum Administration of the curriculum Evaluation Faculty Learners Methods of assessing how a curriculum is functioning Program evaluation (Step 6) Learner/faculty/staff/patient questionnaires Objective measures of skills and performance Focus groups of learners, faculty, staff, patients Other systematically collected data Regular/periodic meetings with learners, faculty, staff Special retreats and strategic planning sessions Site visits Informal observation of curricular components, learners, faculty, staff Informal discussions with learners, faculty, staff Sustenance Management of change Timing of changes Prompts (triggers) of change Establish if the need for change Sustaining the curriculum team Orientation and communication Involvement of faculty, learners and staff Team activities Recognition and celebration Related activities that can strengthen a curriculum Environmental development Faculty development Networking Scholarly activity

1.1.8. Step 8: Dissemination Definition Promote consideration, adaptation or adoption of a curriculum by others The administration of the curriculum to new audiences Why bother? Help address a health problem Stimulate change Provide feedback to curriculum developers Increase interchange and collaboration Prevent redundant work Help curriculum developers achieve recognition and academic advancement What should be disseminated? Parts of the curriculum The whole curriculum Methods of dissemination Presentations of abstracts, workshops, or courses Creation of a multi-institutional interest group Submission of curricular materials to an educational clearinghouse Use of computerized communication systems Preparation and distribution of instructional videotapes or audiotapes Creation and distribution of instructional computer software Publication of an article in a professional journal Publication of a manual, book or book chapter What is known about diffusion of innovations? Relative advantage Compatibility Simplicity Trialability Observability Resources for dissemination Time & effort Personnel Equipment/Facilities Funds

1.2. Curriculum Map

1.2.1. Learning Outcomes Procedural Skills Professionalism Communication Ethics EBM

1.2.2. Curriculum Content (Areas of Expertise)

1.2.3. Assessment OSCE Pre-Entry Post-Entry Written Questions Portfolios

1.2.4. Learning Opportunities Pre-Entry Workshops Lecture Small group discussions PBL Skills Lab e-Learning Self Learning Online Lectures Podcasts Forum Discussions Mentorship

1.2.5. Learning Location Pre-Entry Workshops Site Equipment Booking e-Learning Website Hardware & Software Maintenance

1.2.6. Learning Resources Syllabus Handouts Online Books Online Journals Online Lectures Online Multimedia

1.2.7. Timetable Pre-Entry Workshops e-Learning

1.2.8. Staff Category Appraised Workload Expertise Professional Development Support

1.2.9. Curriculum Management Committee Planning Communication Professionalism Ethics Clinical Skills Information Technology Conveners Systems Phases Outcomes Assessment Funding

1.2.10. Students Intervention Group Personal details Participation Portfolio Progress Control Group Personal details Participation Portfolio Progress

2. Content

2.1. Competencies

2.1.1. Saudi Future Doctor (Dr. Rania Zaini Doctoral Thesis) 1- Clinical skills 1.1. Obtain accurate, organized, systematic and problem-focused medical history. 1.2. Perform accurate physical examination (complete an organ system examination include the mental status examination). 1.3. Examine pregnant patients. 1.4. Recognize, identify and describe abnormality and symptoms. 1.5. Interpret result, evaluate data and correlate to the physical examination. 1.6. Select and apply the most appropriate and cost effective diagnostic procedures. 1.7. Diagnose and identify differentiated diagnoses. 1.8. Record finding. 1.9. Formulate a management plan. 1.10. Write safe prescriptions for different types of drugs (therapeutic instruction). 1.11. Recognize physical, elder, child, and sexual, emotional and spousal abuse. 1.12. Perform primary and secondary assessments of patients with medical and surgical emergency or after trauma. 1.13. Mange appropriate clinical skills in ambulatory settings. 2- Clinical procedures Manage (and record) Perform Competent use of Competent insertion of Manage emergency cases Perform surgical procedures Perform gynecological procedures Other clinical procedures 3- Patient management and investigation 3.1. Understand principles of patient investigations. 3.2. Understand principles of the evaluation and treatment protocols in patient management. 3.3. Recognise common diagnostic tests (biochemistry, haematology, microbiology, pathology, cytology, genetic, immunology, virology, radiology), and interpret results. 3.4. Select and request the most appropriate and cost effective investigation method (clinical - lab - radiology). 3.5. Obtain patients’ informed consent for investigation. 3.6. Interpret investigation result and identify abnormality. 3.7. Manage common medical and surgical emergencies. 3.8. Identify limitations of standard laboratory measurements (to avoid misleading tests). 3.9. Construct an appropriate management plan (diagnostic & therapeutics). 3.10. Inform patient about the prognosis, management and protocol of treatment. 3.11. Monitor patients’ progress and modify management accordingly. 3.12. Follow up normal pregnancy. 3.13. Manage life-threatening conditions or environmental and psychological causes of patient’s illness. 3.14. Manage accident cases with consideration of bioethics and legal responsibility (medico-legal case). 3.15. Manage pre-peri and postoperative care of surgery in various disease interventions. 3.16. Manage psychological, physical and therapeutic pain relief intervention. 4- Effective communication 1.1. Recognize general principles of effective communication. 1.2. Understand ethical concepts in communication. 1.3. Recognize counselling techniques. 1.4. Communicate clearly, considerately and sensitively with patients and their families. 1.5. Communicate effectively by oral and written methods with patients, peers, colleagues (junior and senior), other health professionals, other agencies and general public. 1.6. Use verbal and nonverbal skills effectively. 1.7. Provide information in a manner that ensures patient’s full understanding. 1.8. Communicate effectively with individuals regardless of their social, cultural or ethical background or disability. 1.9. Understand the physical, psychological, social and religious status and needs of patients. 1.10. Break bad and potentially embarrassing news carefully and sensitively. 1.11. Employ effective listening skills. 1.12. Display understanding, compassion and empathy for patients and their families. 1.13. Apply good bedside manners. 1.14. Utilize patient educational materials. 1.15. Counsel patient sensitively and effectively. 1.16. Overcome communication difficulties with disabled or foreigner speakers. 1.17. Communicate with patients with mental illness or severe mental or physical disabilities. 1.18. Help vulnerable patients. 1.19. Communicate as a teacher and patient’s advocator. 1.20. Considers patients’ partnership in counselling, taking decision and keeping them updated. 1.21. The ability to discuss medical errors or professional mistakes honestly and openly to promote patient trust and self-learning. 5- The use of basic, clinical and social sciences in his practice 1.1. The normal structure and function of the human body at cellular, organ and organ system. 1.2. Life cycle and its’ effect on human body’s structure, function, therapeutic response and physical attributes. 1.3. The altered structure and function (pathology and patho-physiology) of the body and its major organ systems that are seen in various diseases or that affect specific age/ sex groups. 1.4. The molecular, biochemical, and cellular mechanisms that are important in maintaining the body’s homoeostasis. 1.5. Epidemic causing factors. 1.6. The most frequent clinical laboratory, roentgenology (imaging) and pathological manifestation of common illness. 1.7. Principles of therapeutic measures in management and symptomatic relief of disease. 1.8. Pharmacological principle of drug and treatment. 1.9. Factors affecting human relationship, the psychological well being of patients, their families and the interaction between human and their social and physical environment. 1.10. Normal and abnormal human behavior and psychological disorders. 1.11. Most frequent and dangerous diagnostic conditions located in the community. 1.12. Principles of fetal and maternal health during pregnancy. 1.13. Physical and behavioral mechanism for maintaining healthy function of body systems. 1.14. The effect of disease on the psychosocial behavior of a person. 1.15. Mechanism and factors of various cases (genetic, developmental, metabolic, toxic, microbiologic, autoimmune, neoplastic, degenerative, and traumatic, environmental, epidemiological, nutrition, immunology, social and occupational) of diseases and the ways in which they operate on the body (pathogenesis). 1.16. Principles and efficiency and resources of traditional and non-traditional therapies, complementary and alternative medicine including herbal medication, preparations, acupuncture and massage. 1.17. Principles of ameliorating of suffering and disability, rehabilitation, palliative care including appropriate pain management and the care of the dying. 1.18. Apply and integrate the clinical, basic, behavioral and social sciences on which medical practice is based on daily practice. 1.19. Psychological manifestation of, illness, families, death, recovery, chronic disease. 1.20. Role of psychology and social workers in the health services. 6- Clinical Reasoning and Decision-making 1.1. Principles governing decision making. 1.2. Reason deductively in solving clinical problems [Retrieve, interpret, analyze, and manage data from laboratory tests, radiology examinations, and clinical procedure for clinical decision-making]. 1.3. Collect and integrate the necessary information. 1.4. Involve patients in decision-making processes when required. 1.5. Demonstrate community oriented approach toward problem solving. 1.6. Build decisions on current practice guidelines. 1.7. Justify the taken decision to patients, colleagues, and public. 1.8. Prioritization (Understand the importance of time in fast and rapid evident decision). 1.9. Base reasoning on the community-oriented approach and regional; epidemiological factors, with applying cost effective relevant investigations. 1.10. Cope with uncertainty, complexity and error in decision-making. 7- Use of Best Evidence Medicine (BEM) 1.1. Principles in EBM. 1.2. Be willing to share evidence with colleagues. 1.3. Be willing to change own decisions or methods regarding the developed evidences. 1.4. Filter, evaluate and reconcile information, to discriminate between types of information sources in term of their accuracy, authority, relevance and availability. 1.5. Apply the scientific basis and evidence of the effectiveness for each of the therapeutic options that are available for patients at different times in the course of the patient’s condition. 1.6. Apply principles of EBM in practice (cost effectiveness in making decision about the utilization of limited medical resources). 1.7. Apply critical appraisal of evidence and then identify the level of each. 1.8. Integrate own clinical expertise with the best available external clinical evidence from systematic research. 1.9. Conduct small research studies for collecting information not available for particular informal decision-making. 1.10. Recognize the link between EBM and audit and the reasons for variation in clinical practice. 1.11. Be aware that clinical evidence may be inappropriate for or in applicable to individual patient. 8- Management of information 1.1. Retrieve and be familiar with local, national, regional, and global sources of information for effective utilization. 1.2. Keep concise patients records (written and electronically). 1.3. Write medical reports, discharge summaries and referral letters. 1.4. Respect patients and physician confidentiality, and demonstrate the legal, ethical and medical issues surrounding patient documentation, including confidentiality and data security (plagiarism). 1.5. Apply adequate IT, resources management and computing skills. 1.6. Retrieve (from electronic database), manage and utilize biomedical information for solving problems and making decisions. 1.7. Send notification for notifiable diseases. 1.8. Select and use competently appropriate audiovisual aids in educational activities (e.g. multimedia, side and overhead projections). 1.9. Keep up-to-date to medical and research resources. 9- Professional behaviour and clinical ethics 9.1. Understand principles of legal responsibility of the medical profession. 9.2. Understand principles of appropriate Islamic professional attitude. 9.3. Recognize own limitation when clinical problems exceed self-capacity, and when to ask for help or to refer the case to a capable colleague. 9.4. Carry out duties with honesty and integrity, motivation and self-discipline in all interactions with patients, their families, colleagues and other health professionals. 9.5. Demonstrate appropriate attitude and Islamic medical ethics in all aspects of practice. 9.6. Respect patients’ dignity, right and privacy regardless to their lifestyle, culture, beliefs, religion, color, gender, disability, age or social or economic status. 9.7. Respect sexual boundaries in the Doctor/Patient relationship. 9.8. Respect the social value, including an appreciation of diversity of human background in a multicultural society. 9.9. Realize that patients’ personal or religious beliefs should not prevent the provision of adequate and appropriate professional medical care. 9.10. Compare ethics and professionalism in the Saudi context with those applied internationally. 9.11. Realize the threats to medical professionalism posed by the conflicts of interest inherited in various financial and organizational arrangements for the practice of medicine. 9.12. Recognize the duty to protect patients and others by taking action if a colleague’s health, performance or conduct is putting patients at risk. 9.13. Utilize resources effectively. 9.14. Appreciate doctors’ responsibility to maintain standards of medical practice. 9.15. Accept the moral, ethical, and legal responsibility involved in professional practice. 9.16. Recognize that patients’ interest is paramount at all times. 9.17. Realize the threat of conflicts that may arise between doctors’ duties towards patients and other legal and ethical commitments. 9.18. Be aware of personal manner, dress, grooming, speech, and interpersonal skills that are expected by the community of medical professional. 9.19. Be willing to accept responsibility for actively educating oneself, colleagues, patients and the public about health and medical issues. 9.20. Understand principles of international and Islamic medical ethics. 9.21. Understand principle of Islamic Fikh in clinical and scientific life and its application (e.g. organ transplantation ethics, human equality, clinical death, removal of resuscitation equipment). 9.22. Practice medicine based on a holistic approach. 9.23. Systematically analyze and define ethical choice in the treatment of individual patients. 9.24. Be willing to monitor the behaviors and competences of professional peers and to deal appropriately with inadequate or unethical behavior, unprofessional practices or conflicts of interest. 10- Population health and health system 1.1. Understand the environment in which medicine is practices in the KSA and patterns of potential or existing health problems in patients, families or communities. 1.2. Understand the important non-biological determinants of poor health and the economic, psychological, occupational, social and cultural factors that contribute to the development and continuation of maladies. 1.3. Understand and respect cultural value of the society. 1.4. Understand principles of hygiene, public health and community medicine. 1.5. Identify community health problems. 1.6. Identify social and cultural factors that influence health care practice particularly in the Saudi context, as well as in other countries and cultures. 1.7. Identify social and cultural factors particularly in the Saudi context that affect occurrence and distribution of diseases. 1.8. Realize the holistic approach of health (environment, economic, social and sanitation). 1.9. Be familiar with roles and services that are provided by the community’s societies and agencies and cooperate with them. 1.10. Value the role of community and family medicine in health care system and their responsibility to educate community. 1.11. Give special attention to the provision of health care to the poor and minorities and high-risk groups. 1.12. Prioritize the community’s health problems in which he/she practice. 1.13. Understand the health economics and healthcare delivery system and its available resources. 1.14. Generalize from individual problems to broader community context. 11- Health promotion and disease control 1.1. Understand the principles of disease prevention and health promotion strategies. 1.2. Understand the principles of etiology, [the scientific method in establishing the causation of disease]. 1.3. Know the epidemiology of common diseases within the defined population and underline mechanisms of transmission. 1.4. Understand principles of pilgrims’ healthcare, infection control and common health complications in these periods. 1.5. Recognize and use opportunities for disease prevention and health promotion. 1.6. Utilize systematic approaches in reducing the incidents and prevalence of the common diseases in the population. 1.7. Identify epidemiological and economical factors that cause infectious, genetic or environmental diseases. 1.8. Identify and support national prevention initiatives and research that aim at health promotion of individuals and communities (e.g. Chronic disease awareness programmes). 1.9. Recognize causes of disease that threaten individuals or community health. 1.10. Cooperate with other health professions and agencies and nongovernmental organizations. 1.11. Collaborate with health professionals and other agencies for controlling pilgrims’ infectious disease and maintaining health community. 1.12. Manage health care during Hajj and Omra. 1.13. Recognize procedures take by MOH to control community diseases. 1.14. Demonstrate a commitment to preventive procedures and the doctors’ role in prompting patients and community health. 1.15. Value the role of health communication via media and other means to facilitate health promotion. 1.16. Plan systematic cost-effective strategy for promoting and improving individual’s and population health. 1.17. Prompt healthy behaviours through encouraging the counsel of individual patients and their families, and public education. (Educator and advocator). 1.18. Attach to hajj community and apply research. 1.19. Participate in national health planning programmes. 1.20. Apply health screening and disease surveillance guidelines, such face cancer screening. 12- Professional development and personal 1.1. Recognize personal and professional limits and then develop an action plan to improve these knowledge and ability. 1.2. Accept and manage complaints, criticism, professional feedback, conflict and change. 1.3. Cope adaptively with stresses, personal and interpersonal tensions, conflicts and problems likely to occur during medical training and practice. 1.4. Keep updated with the development and innovation in medical practice. 1.5. Manage time and set priorities to achieve balance between professional and personal responsibilities. 1.6. Commit to life-long and self-directed learning. 1.7. Recognize the importance of Continuing Medical Education (CME). 1.8. Maintain the highest ethical and professional standards. 1.9. Value the clinical responsibilities and role of the doctor. 1.10. Commitment for higher degree and graduate training. 1.11. Acquire professional values including, excellence, altruism, responsibility, compassion, empathy, honesty, and integrity. 1.12. Communicate with national and international health and research centres. 1.13. Build personal audit and reflect on it periodically. Share Personal development schema with other colleagues. 1.14. Contribute to the departmental audit. 13- Role within health services growth 1.1. Understand the healthcare system and its various aspects, such as policy, administration, finance, and delivery of healthcare at national and local level 1.2. Contribute to the Ministry of Health responsibilities for the use of resources, leadership and supervision of colleagues. 1.3. Work effectively with other as a member or leader of a healthcare team or professional group. 1.4. Practice cost-effective diagnosis and management. 1.5. Keep up to date with relevant current literature and professional guidelines. 1.6. Develop sense of advocacy within the healthcare setting to allocate recourses and direct attention to high demand areas. 1.7. Work collaboratively with other physicians, and other healthcare professionals. 1.8. Integrate one’s work in hospitals, community and primary health centres. 1.9. Contribute to community development with special reference to development and success of health care programmes and health institutions. 1.10. Adhere to health institutes’ rules and regulations. 1.11. Critically appraise the health delivery system, and then participate and promote its development. 1.12. Be aware of health organizations nationally and internationally. 1.13. Acknowledge and respect the role of other healthcare professions. 14- Research 1.1. Understand ethical responsibilities when conducting research. 1.2. Understand the principles of scientific methodology of research. 1.3. Engage in academic writing. 1.4. Demonstrate library and IT skills. 1.5. Show statistical understanding and application. 1.6. Apply evidence-based critic of own or others’ researches and articles. 1.7. Contribute or conduct community-oriented research. 1.8. Demonstrate minim research skills (Apply for research grant). 1.9. Develop well structure scientific paper and effective research synopsis. 1.10. Contribute to the generation of knowledge and professional education of junior colleagues. 1.11. Demonstrate commitment to conducting relevant health research (especially health system research) that contributes to the solution of health problems and evaluation of medicine.

2.1.2. CanMEDS Competencies Medical Expert 1. Function effectively as consultants, integrating all of the CanMEDS Roles to provide optimal, ethical and patient-centered medical care; 2. Establish and maintain clinical knowledge, skills and attitudes appropriate to their practice; 3. Perform a complete and appropriate assessment of a patient; 4. Use preventive and therapeutic interventions effectively; 5. Demonstrate proficient and appropriate use of procedural skills, both diagnostic and therapeutic; 6. Seek appropriate consultation from other health professionals, recognizing the limits of their expertise. Communicator 1. Develop rapport, trust and ethical therapeutic relationships with patients and families; 2. Accurately elicit and synthesize relevant information and perspectives of patients and families, colleagues and other professionals; 3. Accurately convey relevant information and explanations to patients and families, colleagues and other professionals; 4. Develop a common understanding on issues, problems and plans with patients and families, colleagues and other professionals to develop a shared plan of care; 5. Convey effective oral and written information about a medical encounter. Collaborator 1. Participate effectively and appropriately in an interprofessional healthcare team; 2. Effectively work with other health professionals to prevent, negotiate, and resolve interprofessional conflict. Manager 1. Participate in activities that contribute to the effectiveness of their healthcare organizations and system; 2. Manage their practice and career effectively; 3. Allocate finite healthcare resources appropriately; 4. Serve in administration and leadership roles, as appropriate. Heath Advocate 1. Respond to individual patient health needs and issues as part of patient care; 2. Respond to the health needs of the communities that they serve; 3. Identify the determinants of health of the populations that they serve; 4. Promote the health of individual patients, communities and populations. Scholar 1. Maintain and enhance professional activities through ongoing learning; 2. Critically evaluate information and its sources, and apply this appropriately to practice decisions; 3. Facilitate the learning of patients, families, students, residents, other health professionals, the public, and others, as appropriate; 4. Contribute to the creation, dissemination, application, and translation of new medical knowledge and practices. Professional 1. Demonstrate a commitment to their patients, profession, and society through ethical practice; 2. Demonstrate a commitment to their patients, profession, and society through participation in profession-led regulation; 3. Demonstrate a commitment to physician health and sustainable practice.

2.2. Topics to be Covered

2.3. Ethics Curriculum

2.3.1. UK I INFORMED CONSENT AND REFUSAL OF TREATMENT * The significance of autonomy: respect for persons and for bodily integrity * Competence to consent: conceptual, ethical and legal aspects * Further conditions for ethically acceptable consent: adequate information and comprehension, non-coercion * Treatment without consent and proxy consent - when and why morally and legally justifiable * Assault, battery, negligence and legal standards for disclosure of information * Problems of communicating information about diagnosis, treatment and risks: the importance of empathy. II THE CLINICAL RELATIONSHIP - TRUTHFULNESS, TRUST AND GOOD COMMUNICATION * The ethical limits of paternalism towards patients * The significance of honesty, courage, prudence and facilitative attitudes: virtues in the practice of good medicine * Legal and ethical boundaries of clinical discretion to withhold information * Practical difficulties with truth-telling in medicine: inter/intra professional conflicts and other barriers to good communication * The ethical and legal importance of good communication skills and the significance of the patient's narrative (as distinct from other professional narratives) in building relationships of trust. The importance of cultural, gender, inter-generational, religious and racial sensitivity. III CONFIDENTIALITY AND GOOD CLINICAL PRACTICE * Professional information, privacy and respect for autonomy * Trust, secrecy and security in the sharing of information: the practical demands of good practice. * The patient and the family: potential moral and legal tensions * Disclosure of information: public versus private interests * Compulsory and discretionary disclosure of confidential information: professional and legal requirements. IV MEDICAL RESEARCH * Historical and contemporary examples of abuses of medical research * Individual rights and moral tension between the duty of care to the individual and the interests of others. Therapeutic and nontherapeutic research * Professional and legal regulation of medical research. * The ethical significance of the distinction between research, audit and innovative and standard therapy as well as between patients and healthy volunteers * Research and vulnerable groups: ethical and legal boundaries of informed and proxy consent * Research on animals: ethical debates and legal requirements. V HUMAN REPRODUCTION * Ethical debates about, and the legal status of, the embryo/fetus * The maternal-fetal relationship: ethical tensions * Abortion: professional guidelines, legal requirements and debates about the use of tissue from aborted fetuses * Sterilisation: ethical and legal issues * Pre and postnatal screening and testing: ethical issues concerning informed consent and the determination of the interests of the future child * Assisted conception: legal boundaries and ethical disputes. VI THE 'NEW GENETICS * Gene therapy: ethical issues concerning the distinction between treating the abnormal and improving the normal * Somatic versus germline treatment and research: ethical and legal arguments * Eugenics versus patient-centred care * Genetic counselling: responsibilities to patients versus responsibilities to families * Benefits and dangers of genetic testing and screening after birth: the risks of unwelcome information and of genetic stigmatisation * Cloning: genetic versus personal identity - ethical implications. VII CHILDREN * Respect for the rights of children: evolution of current ethical issues * The relevance of age in the determination of competence to consent to or refuse treatment * Ethical debates about legal boundaries of consultation with younger and older children as regards consent to treatment * The doctor/parent relationship: proxy decisionmaking and protecting children's interests * Good ethical and legal practice in reporting suspected child abuse. VIII MENTAL DISORDERS AND DISABILITIES * Definitions of mental disorders, mental incapacity, (including mental illness, learning disability and personality disorder) * Ethical and legal implications of serious mental illness: civil incapacities, vulnerability and reduced responsibility * Treatment, legal detention of, and research on, the seriously mentally disordered with or without consent * Patient, family and community: ethical and legal tensions. IX LIFE, DEATH, DYING AND KILLING * Palliative care, length and quality of life and good clinical practice * Attempting ethically to reconcile non-provision of life-prolonging treatment with the duty of care: killing and letting die, double effect, ordinary and extra-ordinary means * Withholding and withdrawing life-prolonging treatment - and potentially shortening life - in legally acceptable ways * Euthanasia and assisted suicide: ethical and legal arguments * Transplantation: ethical and legal issues * Death certification and the role of the coroner's court. X VULNERABILITIES CREATED BY THE DUTIES OF DOCTORS AND MEDICAL STUDENTS * Public expectations of medicine: difficulties in dealing with uncertainty and conflict. Ethical importance of good inter- and intra- professional communication and teamwork * The General Medical Council. Professional regulation, standards, and the Medical Register. Implications for students and their relationship with patients * Responding appropriately to clinical mistakes: personal, legal and ethical responsibilities. Unethical and unsafe practice in medicine: "whistleblowing" * The law of negligence, NHS complaints and disciplinary procedures * The health of doctors and students and its relationship to professional performance: risks, sources of help and duties to disclose. * Medical ethics and the involvement of doctors in police interrogation, torture and capital punishment. XI RESOURCE ALLOCATION * Inadequate resources and distributive justice within the National Health Service (NHS): the law * Theories and criteria for equitable health care: needs, rights, utility, efficiency, desert, autonomy * Debates about rationing: personal, local, national and international perspectives. Markets and ethical differences between competing health care delivery systems * Boundaries of responsibility of individuals for their own illnesses and ethical implications. XII RIGHTS * Conceptions of rights - what are they? * Links between rights and duties and responsibilities * International declarations of human rights * The importance of the concept ofhuman rights for medical ethics * Debates about the centrality of rights for good professional practice in medicine * Rights and justice in health care.

2.3.2. Australasian Principles Beneficence (the obligation to provide benefits); Non-maleficence (the obligation to avoid harm); Respect for autonomy (the obligation to respect the decision-making capacity of others); Justice (the obligation of fairness). Core Knowledge Foundations Topics Core Attitudes Honesty, integrity and trustworthiness Critical self-appraisal (including recognition of limitations and errors) Empathy and compassion Respect for (the dignity of) patients as people Respect for the roles of other healthcare professionals in the care of the patient Responsibilities of the medical professional towards the local and global community Responsibility and reliability Commitment to clinical competence and lifelong education Commitment to self-care

2.4. Communication Skills Curriculum

2.4.1. Types Content Skills (what healthcare professionals communicate) The substance of their questions and responses The information that they gather and give The treatment they discuss Process Skills (how they do it) The ways in which they communicate with patients How they go about discovering the history or providing information The verbal and non-verbal skills that they use How they develop the relationship with the patient The way they organize and structure communication Perceptual Skills (what they are thinking and feeling) Their internal decision-making, clinical reasoning and problem-solving skills Their attitudes and intentions, values and beliefs Their awareness of feelings and thoughts about the patient, about the illness and about other issues that may be concerning them Their awareness of their own self-concept and confidence, of their own biases and distractions.

2.4.2. The Calgary-Cambridge Observation Guide Elements Structure (how do we organize communication skills?) Skills (what are the skills that we are trying to promote?) Validity (what evidence is there that these skills make a difference in doctor-patient relationship?) Breadth (what is the scope of the communication curriculum?) Calgary-Cambridge Guide Communication Process Skills INITIATING THE SESSION GATHERING INFORMATION PROVIDING STRUCTURE TO THE CONSULTATION BUILDING RELATIONSHIP EXPLANATION AND PLANNING CLOSING THE SESSION OPTIONS IN EXPLANATION AND PLANNING (includes content and process skills) Calgary-Cambrdige Guide Communication Content Patient's Problem List Exploration of Patient's Problems Background Information - Context Physical Examination Differential Diagnosis - Hypotheses Physician's Plan of Management Explanation and Planning with Patient

2.4.3. Teaching Methods Didactic Lectures Assigned literature study Handouts Critical reading of research evidence Tutorial and discussion groups Project work Demonstrations (live or videotaped) Seminars and panels Training workshops e-learning Experiential Video/Audio recordings Real patients Simulated patients Roleplay

2.4.4. Conceptual framework for systematic communication training Underlying assumptions Untitled Untitled Untitled Untitled Organizational schema for communication programmes Goals of medical communication Tasks of the medical interview Borad categories of skills Principles that characterise effective communication Focuses of learning and assessment

2.4.5. Domains of Communication in Medicine 1. Physician-patient interaction Accuracy, efficiency, supportiveness Information gathering Explanation and planning, decision making, negotiation Relationship building, relational competence Counselling and psychosocial therapy Third-party communication (patient's family, significant others) Enhancing patients' ability to communicate with healthcare professionals and within the system 2. Communication issues Culture Ethics Gender Special needs patients Prevention, motivation to change Dealing with feelings Confrontation Breaking bad news, death and dying Addiction Malpractice 3. Communication with self Thought process Clinical reasoning and problem solving Attitudes Feelings Reflection/self-evaluation Dealing with stress and tension, personal flexibility Handling mistakes Handling failures Biases 4. Communication with other professionals: coordination of care within and between teams Colleagues in medicine Colleagues in nursing and the allied health professions Healthcare teams Healthcare providers in complementary and alternative medicine Administrators Researchers Making presentations and lectures Discussion leadership 5. Communication at a distance Telephone Medical records Fax Letters Computer-assisted interviewing and consultations Telemedicine Databases, websites, electronic networks Newspapers, scientific journals 6. Health promotion via mass media, communicating with the public Pamphlets, brochures, posters Radio and TV campaigns Advertising Edutainment Public speaking Talking to the press 7. Communicating with the "system" (government, community, hospital) Influencing health policy Talking with government, community and agency representatives Inluencing and coping with change

3. Curriculum Delivery & Implementation

3.1. Pre-internship Workshops

3.2. Website

3.2.1. Moodle Activity Module Chat Podcasting Videoconferencing Advanced Book Appointment Assessments Attendance Audio Presentations Book Bookings Brainstorm Certificates ChapterTh!sVideo Course Resume and Start Covcell Whiteboard Database Module DFwiki Dialogue Dimdim Web Meeting Activity Elluminate Live Block ActiveUsers Media Administration Marking Block Apreso Streaming Server Block Comment 'N Rate RSS's Completion Report Compliance Block Contact Form Block Contacts Block Content Management System Course Contacts Block Course Creation Block Course Date Manager Block Course Dedication Block Course Management Block Course Menu Covcell Course Standing Covcell Deadline Countdown Criteria Reference Display (1.9) and CSV Import (pre 1.9) Elgg Integration Block eMail Enhanced Messages Block Enhanced User Administration Enrolment Key Generator Filter Advanced FLV Filter Enhanced Glossary Small Hack FLV resource hack All My Grades (Gradebook Mod) Bulk Course and Category Creation Tool (Upload CSV) Bulk Course Upload Tool Calendar Event Reminder System Resource Type Video Conversion Question Import/Export Format Aiken question import format AON question import format Course Format Collapsible Content Display Course Layout Editor Course Report Course Reports Plug In Time Tine Quiz Report Detailed Responses Question Type Drag and Drop Drang and Drop Matching Question Type Drag and Drop Ordering Question Type Embedded Answers Major Patch Enhanced Messaging for Moodle 1.8.x Enrolment Method Enrol Shibboleth