Step 1: Problems Identification & General Needs Assessment, Identification & Characterization of the Health Care Problem, Whom does it affect?, Patients, Health Care Professionals, Society, What does it affect?, Clinical outcomes, Quality of life, Quality of health care, Use of health care and other resources, Medical & non-medical costs, Patient and provider satisfaction, Work & productivity, Societal function, What is the quantitative and qualitative importance of the effects?, Analysis of the current approach, What is currently being done by, Health care professionals, Medical educators, Society, What personal & environmental factors affect the problem?, Predisposing, Enabling, Reinforcing, 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, Published literature, Reports by professional societies or government agencies, Documents submitted to educational clearinghouses, Curriculum documents from other institutions, Patient education materials prepared by foundations or professional organizations, Public health statistics, Clinical registry data, Administrative claims data, Use of Consultants & Experts, Informal consultations, Formal consultations, Meetings of experts, Collection of New Information, Survey of patients, practitioners, or experts, Focus groups, Nominal group techniques, Group-mailed delphi technique, Observation of tasks performed by practitioners, Study of ideal performance cases or role model practitioners
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, Cognitive, Knowledge, Problem-solving abilities, Affective, Attitudes, Values, Beliefs, Role expectations, Psychomotor skills, History, Physical examination, Procedures, Counseling, Current performance, Perceived deficiencies and learning needs, Preferences and experiences regarding different learning strategies, Time, Format, Methods, Characteristics of the learners' and the curriculum's environment, Barriers, Enabling Factors, Reinforcing Factors, Resources available to learners, Patients and clinical experiences, Information resources, Computers, Role models, teachers, mentors, Other, Methodology, General considerations, Time, effort & resources, What standards of representativeness and accuracy will be required?, Will subjective or objective, quantitative or qualitative data be preferable?, Seek advice or mentorship from those with expertise, Pilot, Choice of methods, Informal discussions, Formal interviews, Focus group discussions, Questionnaires, Direct, Mailed, Online, Direct observation, Tests, Audits of current performance, Strategic planning sessions for the curriculum
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, Cognitive, Psychomotor, Affective, Process Objectives, Individual process objectives, Program process objectives, Outcome Objectives
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, Events, Locations, Directions, Written curricular materials, Readings, Cases, Questions, Suggestions/resources for additional learning, Educational Methods, Reading, Lecture, Live, Online, Discussion, Problem-solving exercises, Programmed learning, Learning projects, Role models, Demonstration, Real-life experiences, Simulated experiences, Artificial models, Standardized patients, High-fidelity simulation, Audio or video review of learner, Behavioral/environmental interventions
Step 5: Implementation, Procurement of Support, Internal, From, Those with administrative authority, Dean's offices, Hospitals administration, Department chairs, Program directors, Division directors, Faculty, Learners, Other stakeholders, For, Personnel, Resources, Political support, External, From, Ministry of Higher Education, Administration, Ministry of Health, Saudi Commission of Health Specialties, For, Funding, Political support, Curricular development resources, Faculty development resources, Identification & Procurement of resources, Funding, Teaching Materials, Physical Resources, Personnel, Faculty, Secretarial and other support staff, Patients, Other, Time, Faculty, Support Staff, Learners, Facilities, Space, Equipment, Clinical sites, Funding/Costs, Direct financial costs, Hidden or opportunity costs, Identification & address of barriers to implementation, Financial & other resources (time), Competing demands, People, Attitudes, Job/role security, Power, Authority, Develop administrative mechanisms to support the curriculum, Administrative structure, Delineate responsibilities, Delineate decision making, Communication, Content, Rationale, Goals & Objectives, Information about, Curriculum, Learners, Faculty, Facilities, Equipment, Scheduling, Changes in the curriculum, Evaluation studies, Mechanisms, Memos, Meetings, Syllabus materials, Site visits, Reports, Operations, Preparation & distribution of schedules & curricular materials, Collection, collation and distribution of evaluation data, Curricular revisions and changes, Introduction of the curriculum, Pilot, Phase-in, Full implementation, Refinement of the curriculum over successive cycles
Step 6: Evaluation & Feedback, Tasks, 1. Identify users, Participants, Future learners, Faculty, Curriculum developers, Administrative stakeholders, Government & funding agencies, 2. Identify uses, Level of assessment, Individual, Program, Both, Method, Summative, Formative, Both, 3. Identify resources, Time, Collection, analysis and reporting of evaluation results, Personnel, Staff to help in the collection and collation of data and distribution of reports, Statistical support, Computer expertise, Equipment, Appropriate computer hardware and software, Facilities, Funds, Sources, Internal, External, Budget justification, 4. Identify evaluation questions, Related to the specific measurable learner, process or outcome objectives, Who will do how much (how well) of what by when?, 5. Identify evaluation designs, Posttest only (pre-experimental), Pretest-posttest (pre-experimental), Controlled pretest-posttest (quasi-experimental), Randomized controlled posttest (true experimental), Randomized controlled pretest-posttest (true experimental), 6. Choose measurement methods and construct instruments, Choice of methods, Rating forms, Self-assessment forms, Essays of respondent's experience, Written or computer interactive tests, Oral examinations, Questionnaires, Individual interviews, Group interviews/discussions, Direct observation, Performance audits, Construction of measurement instruments, Methodological rigor, Check for existing instruments, Reliability, Inter-rater, Intra-rater, Test-retest (Stability), Alternate-from (Equivalence), Homogeneity, Validity, Face, Content, Criterion, Pedictive, Construct, Content, Independent variables, Curriculum itself, Previous or concurrent training, Environmental factors, Dependent variables, Knowledge or skill attainment, Real-life performance, Clinical outcomes, Format, Length, Clear & unambiguous items, Appropriate response scales, User-friendly, Engaging, Pilot, 7. Address ethical concerns, Confidentiality, Access, Consent, Resource allocation, Potential impact of the evaluation, 8. Collect data, Response rates, Efficiency, Impact on instrument design, Assignment of responsibility, 9. Analyze data, Relation to evaluation questions, Relation to measurement instruments, Choice of statistical methods, 10. Report results
Step 7: Curriculum Maintenance & Enhancement, Dynamic nature of curricula, Understanding one's curriculum, The written or intended curriculum, Goals & objectives, Are they understood and accepted by all involved in the curriculum?, Are they realistic?, Can some be deleted?, Should some be altered?, Do others need to be added?, Are they measurable?, Content, Is the amount just right, too little, or too much?, Does the content still match the objectives?, Can some content be deleted?, Should other content be updated or added?, Curricular materials, Are they being read and used?, How useful are the various components perceived to be?, Can some be deleted?, Should others be altered?, Should new materials be added?, Methods, Are they well executed by faculty?, Are they well received by learners?, Have they been sufficient to achieve curricular objectives?, Are additional methods needed to prevent decay of learning?, Congruence, Does the curriculum on paper match the curriculum in reality?, If not, is that a problem?, Does one or the other needed to be changed?, The environment/setting of the curriculum, Space, Is there sufficient space to support the various activities of the curriculum?, For clinical curricula, is there sufficient space for learners to:, see patients?, consult references?, meet with perceptors?, Equipment and supplies, Are there sufficient equipment and supplies to support the curriculum while in progress?, Are there sufficient equipment and supplies to support and reinforce learning after completion of the curriculum?, Examples, Is there audiovisual equipment to support learning of interviewing skills?, Are there sufficient, easily accessible references to support clinical practice experiences?, Do the residents' clinical practices have the equipment to support the performance of learned skills and procedures?, Clinical experience, Is there sufficient concentrated clinical experience to support learning during the course of the curriculum?, Is there sufficient clinical experience to reinforce learning after completion of the main curriculum?, If there is insufficient patient volume or case mix, do alternative clinical experiences need to found or do alternative approaches need to be developed such as a simulated patient program?, Are curricular objectives and general programmatic goals (e.g., efficiency, cost-effectiveness, customer service, record keeping, communication between referring and consulting practitioners, and provision of needed services) supported by clinical practice operations?, Do support staff support the curriculum?, Learning climate, Is the climate cooperative or competitive?, Are learners encouraged to communicate or to hide what they don't know?, Is the curriculum sufficiently learner-centered and -directed? sufficiently teacher-centered and -directed?, Are learners encouraged and supported in identifying and pursuing their own learning needs and goals related to the curriculum?, Associated settings, Is learning from the curriculum supported and reinforced in the learners' prior, concomitant and subsequent settings?, If not, is there an opportunity to influence those settings?, Administration of the curriculum, Scheduling, Are schedules understandable, accurate, realistic and helpful?, Are they put out far enough in advance?, Are they adhered to?, How are scheduling changes managed?, Preparation and distribution of curricular materials, Is this being accomplished in a timely and consistent manner?, Collection, collation and distribution of evaluation information, Is this being accomplished in a timely and consistent manner?, If there are several different evaluation forms, can they be consolidated into one form or administered at one time, to decrease respondent fatigue?, Communication, Are changes in and important information about the curriculum being communicated to the appropriate individuals in a user-friendly, understandable, and timely manner?, Evaluation, Congruence, Is what being evaluated consistent with the goals, objectives, content, and methods of the curriculum?, Does the evaluation reflect the main priorities of the curriculum?, Response rate, Is it sufficient to be representative of learners, faculty or others involved in or affected by the curriculum?, Accuracy, Is the information reliable and valid?, Usefulness, Does the evaluation provide timely, easily understandable, and useful information to learners, faculty, curriculum coordinators and relevant others?, Faculty, Reliability/accessibility, How reliable are the faculty members in performing their curricular responsibilities?, Are they devoting more or less time to the curriculum than expected?, How accessible are faculty members in responding to learner questions and individual learner needs?, Do faculty members schedule free time for discussion before or after sessions?, Teaching/facilitation skills, How skillful are faculty members at assessing the learners' needs, imparting information, asking questions, providing feedback, stimulating self-directed learning, and creating a learning environment that is open, honest, exciting and fun?, Nature of the learner-faculty relationship, Is the relationship more authoritative or collaborative? more teacher-centered or learner-centered?, For clinical precepting, does the learner see patients on his or her own?, Does the learner observe faculty while faculty are seeing patients or while faculty are assuming other roles?, Are the learners exposed to faculty members' professional life outside the curriculum, e.g., clinical practice, research, community work?, Do learners get to know faculty members as persons and get to see how faculty balance professional, family and personal life?, Do faculty serve as good role models?, Satisfaction, Do faculty members feel adequately recognized and rewarded for their teaching?, Do they feel that their role is an important one?, Are they enthusiastic?, How satisfied are faculty members with clinical practice, teaching, and their professional lives in general?, Involvement, To what extent are faculty involved in the curriculum?, Do faculty complete evaluation forms in a timely manner?, Do they attend scheduled meetings?, Do they provide useful suggestions for improving the curriculum?, Learners, Achievement of curriculum objectives, Have cognitive, affective, psychomotor, process and outcome objectives been achieved?, Are learners responsible in meeting their obligations to the curriculum?, Satisfaction, How satisfied are learners with various aspects of the curriculum?, Involvement, To what extent are learners involved in the curriculum?, Do they complete evaluation forms in a timely manner?, Do they attend scheduled activities and meetings?, Do they provide useful suggestions for improving the curriculum?, Application, Do learners apply their learning in other settings and contexts?, Do they teach others what they have learned?, 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, Midcourse, End-of-cycle, End-of-year, Prompts (triggers) of change, Informal feedback, Evaluation results, The evolving needs of learners, faculty, institutions and society, Changes in available resources, Establish if the need for change, is sufficiently important, affects a significant number of people, will persist if it is not addressed, Sustaining the curriculum team, Orientation and communication, Domains, Goals and objectives, Guidelines/standards, Evaluation results, Program changes, Rationale for above, Learner, faculty, staff, patient experience, Mechanisms, Syllabi/handouts, Meetings, Memos, Newsletters, Involvement of faculty, learners and staff, Domains, Goal & objective setting, Guideline development, Curricular changes, Determining evaluation and feedback needs, Mechanisms, Questionnaires/interviews, Informal one-on-one meetings, Group meetings, Task group membership, Strategic planning, Team activities, Team teaching/coaching, Faculty development activities, Retreats, Task groups to analyze assess needs, Strategic planning groups, Recognition and celebration, Private communication, Public recognition, Rewards, Parties and other social gathering, Related activities that can strengthen a curriculum, Environmental development, Creates new opportunities for the curriculum, Reinforce learning that has occurred, Support its application by learners, Faculty development, Scope, Institutionwide, Regional, National, Focus, Specific content area, Time management, Teaching skills, Curriculum development, Management, Research skills, Networking, Scholarly activity, Types, Original research, Critical reviews, Focus, Subject matter of the curriculum, Methods of teaching & learning
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, To individuals and groups within specific institutions, Regional, national and international professional meetings, 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, Critical Appraisal of an Article on Curriculum, Rationale, Is there a well reasoned need for the curriculum? (problem identification and general needs assessment), Setting, Is the setting clearly described?, Is the setting sufficiently representative to make the article of interest to readers? (external validity), Subjects, Are the learners clearly described?, Specific profession and specialty within profession, Educational level, e.g., 3rd year medical students or PGY-2 residents, Needs assessment of targeted learners, Sociodemographic information, Are the learners sufficiently representative to make the article of interest to readers? (external validity), Educational Intervention, Are the relevant objectives clearly expressed?, Are the objectives meaningful and congruent with the rationale for the curriculum?, Are the educational content and methods described in sufficient detail to be replicated? If written description is incomplete, are educational materials offered., Are the required resources adequately described (e.g., faculty, faculty development, equipment)?, Evaluation Methods, Are the methods described in sufficient detail so that the evaluation is replicable?, Is the evaluation question clear? Are independent and dependent variables clearly defined?, Are the dependent variables meaningful and congruent with the rationale of the curriculum? e.g., is performance measured instead of competence, skill instead of knowledge, when those are the desired or most meaningful effects?, Are long-term as well as short-term effects measured?, Is the evaluation design clear and sufficiently strong to answer the evaluation question?, Has a power analysis been conducted to determine the likelihood that the evaluation would detect an effect of the desired magnitude?, Are raters blinded to the status of learners? have inter- and intra-rater reliability been assessed?, Are the measurement instruments described or displayed in sufficient details? If incompletely described or displayed, are they offered or referenced?, Do the measurement instruments seem to possess face validity? Are they congruent with the evaluation question?, Have the reliability and validity of the measurement instruments been assessed? Are the reliability and validity sufficient to ensure the accuracy of the measured instruments? Have the measurement instruments been used elsewhere? Have they attained a level of general acceptance?, Are the statistical methods (parametric vs non-parametric) appropriate for the type of data collected (nominal, ordinal, numerical; normally distributed vs. skewed; very small vs. very large sample size)? Are the specific statistical tests appropriate to answer the evaluation question? Have potentially confounding independent variables been controlled for by random allocation or the appropriate statistical methods?, Are the evaluation methods, as a whole, sufficiently rigorous to ensure the internal validity of the evaluation?, Results, Is the response rate adequate?, Are the results of sufficient interest to be worthy of publication?, Conclusions, Are the conclusions justified based upon the methodology of the study or report?, Are the strengths and limitations of the methodology acknowledged?, Is the paper's contribution to the existing knowledge base clearly and accurately described?, 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
Learning Outcomes, Procedural Skills, Professionalism, Communication, Ethics, EBM
Curriculum Content (Areas of Expertise)
Assessment, OSCE, Pre-Entry, Post-Entry, Written, Questions, Portfolios
Learning Opportunities, Pre-Entry Workshops, Lecture, Small group discussions, PBL, Skills Lab, e-Learning, Self Learning, Online Lectures, Podcasts, Forum Discussions, Mentorship
Learning Location, Pre-Entry Workshops, Site, Lecture Hall, Small Groups Rooms, Skills Lab, Equipment, Booking, e-Learning, Website, Hardware & Software, Maintenance
Learning Resources, Syllabus, Handouts, Online Books, Online Journals, Online Lectures, Online Multimedia
Timetable, Pre-Entry Workshops, e-Learning
Staff, Category, Appraised Workload, Expertise, Professional Development, Support
Curriculum Management, Committee, Planning, Communication, Professionalism, Ethics, Clinical Skills, Information Technology, Conveners, Systems, Phases, Outcomes, Assessment, Funding, Teaching Activities
Students, Intervention Group, Personal details, Participation, Portfolio, Progress, Control Group, Personal details, Participation, Portfolio, Progress
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), 2.1. Basic parameters (blood pressure, radial pulse rate and body temperature, weight and mass)., 2.2. Blood sampling / CBC (arterial and venous)., 2.3. Urine pregnancy test., 2.4. Perform and interpret a 12 lead ECG., 2.5. CPR (Cardiopulmonary Resuscitation)., Perform, 2.6. Sterile Technique (e.g. gloving, sterile and dressing change)., 2.7. Universal precautions (infectious)., 2.8. Collection of samples (Swabs from both anterior nares, throat and skin)., 2.9. Injections (intramuscular and subcutaneous, intravenous, interadermal)., 2.10. Venepuncture (including blood culture)., 2.11. Arterial punctures [for blood gases]., 2.12. Parenteral drug administration., 2.13. Calculate dosage of insulin., 2.14. Dosage and administration of insulin and use / prescribing of sliding scales., 2.15. Administration of oxygen therapy., 2.16. Administration of oxygen by mask ventilation., 2.17. Basic airway management., 2.18. Complete ACLS., Competent use of, 2.19. Otoscope., 2.20. Ophthalmoscope for retinal examination., 2.21. Nebulizer., Competent insertion of, 2.22. IV line., 2.23. Intravenous cannulae., 2.24. Foley catheter., 2.25. Male and female urinary catheterization., 2.26. Nasogastric tube (NGT)., Manage emergency cases, 2.27. Control of gross external hemorrhage., 2.28. First aid., 2.29. Manage poisoning or drug overdose., 2.30. Basic wound sterilisation and dressing., 2.31. Basic life support for adult., 2.32. Basic life support for children., 2.33. Basic life support for infants., 2.34. Manage simple fractures., 2.35. Manage acute pulmonary edema., 2.36. Cardiac pulmonary resuscitation (CPR)., 2.37. Life sustaining skills (ACLS)., 2.38. Usage of an ambu bag., 2.39. Cervical immobilization., Perform surgical procedures, 2.40. Scrubbing., 2.41. Scrubbing in operating room., 2.42. Skin suturing., 2.43. Suturing laceration., 2.44. Local anesthesia., Perform gynecological procedures, 2.45. Obstetric scrubbing, gloving and dressing., 2.46. Normal vaginal delivery., 2.47. Detect fetal heart sound., 2.48. Assessment of labor., 2.49. Perform a pelvic examination., Other clinical procedures, 2.50. Renal / thyroid / liver/ function test, 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.
CanMEDS Competencies, Medical Expert, 1. Function effectively as consultants, integrating all of the CanMEDS Roles to provide optimal, ethical and patient-centered medical care;, 1.1. Effectively perform a consultation, including the presentation of well-documented assessments and recommendations in written and/or verbal form in response to a request from another health care professional, 1.2. Demonstrate effective use of all CanMEDS competencies relevant to their practice, 1.3. Identify and appropriately respond to relevant ethical issues arising in patient care, 1.4. Effectively and appropriately prioritize professional duties when faced with multiple patients and problems, 1.5. Demonstrate compassionate and patient-centered care, 1.6. Recognize and respond to the ethical dimensions in medical decision-making, 1.7. Demonstrate medical expertise in situations other than patient care, such as providing expert legal testimony or advising governments, as needed, 2. Establish and maintain clinical knowledge, skills and attitudes appropriate to their practice;, 2.1. Apply knowledge of the clinical, socio-behavioural, and fundamental biomedical sciences relevant to the physician’s specialty, 2.2. Describe the RCPSC framework of competencies relevant to the physician’s specialty, 2.3. Apply lifelong learning skills of the Scholar Role to implement a personal program to keep up-todate, and enhance areas of professional competence, 2.4. Contribute to the enhancement of quality care and patient safety in their practice, integrating the available best evidence and best practices, 3. Perform a complete and appropriate assessment of a patient;, 3.1 Effectively identify and explore issues to be addressed in a patient encounter, including the patient’s context and preferences, 3.2 For the purposes of prevention and health promotion, diagnosis and or management, elicit a history that is relevant, concise and accurate to context and preferences, 3.3 For the purposes of prevention and health promotion, diagnosis and/or management, perform a focused physical examination that is relevant and accurate, 3.4 Select medically appropriate investigative methods in a resource-effective and ethical manner, 3.5 Demonstrate effective clinical problem solving and judgment to address patient problems, including interpreting available data and integrating information to generate differential diagnoses and management plans, 4. Use preventive and therapeutic interventions effectively;, 4.1 Implement an effective management plan in collaboration with a patient and their family, 4.2 Demonstrate effective, appropriate, and timely application of preventive and therapeutic interventions relevant to the physician’s practice, 4.3 Ensure appropriate informed consent is obtained for therapies, 4.4 Ensure patients receive appropriate end-of-life care, 5. Demonstrate proficient and appropriate use of procedural skills, both diagnostic and therapeutic;, 5.1 Demonstrate effective, appropriate, and timely performance of diagnostic procedures relevant to their practice, 5.2 Demonstrate effective, appropriate, and timely performance of therapeutic procedures relevant to their practice, 5.3 Ensure appropriate informed consent is obtained for procedures, 5.4 Appropriately document and disseminate information related to procedures performed and their outcomes, 5.5 Ensure adequate follow-up is arranged for procedures performed, 6. Seek appropriate consultation from other health professionals, recognizing the limits of their expertise., 6.1 Demonstrate insight into their own limitations of expertise via self-assessment, 6.2 Demonstrate effective, appropriate, and timely consultation of another health professional as needed for optimal patient care, 6.3 Arrange appropriate follow-up care services for a patient and their family, Communicator, 1. Develop rapport, trust and ethical therapeutic relationships with patients and families;, 1.1. Recognize that being a good communicator is a core clinical skill for physicians, and that effective physician-patient communication can foster patient satisfaction, physician satisfaction, adherence and improved clinical outcomes, 1.2. Establish positive therapeutic relationships with patients and their families that are characterized by understanding, trust, respect, honesty and empathy, 1.3. Respect patient confidentiality, privacy and autonomy, 1.4. Listen effectively, 1.5. Be aware and responsive to nonverbal cues, 1.6. Effectively facilitate a structured clinical encounter, 2. Accurately elicit and synthesize relevant information and perspectives of patients and families, colleagues and other professionals;, 2.1. Gather information about a disease, but also about a patient’s beliefs, concerns, expectations and illness experience, 2.2. Seek out and synthesize relevant information from other sources, such as a patient’s family, caregivers and other professionals, 3. Accurately convey relevant information and explanations to patients and families, colleagues and other professionals;, 3.1. Deliver information to a patient and family, colleagues and other professionals in a humane manner and in such a way that it is understandable, encourages discussion and participation in decision making, 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;, 4.1. Effectively identify and explore problems to be addressed from a patient encounter, including the patient’s context, responses, concerns, and preferences, 4.2. Respect diversity and difference, including but not limited to the impact of gender, religion and cultural beliefs on decision-making, 4.3. Encourage discussion, questions, and interaction in the encounter, 4.4. Engage patients, families, and relevant health professionals in shared decision-making to develop a plan of care, 4.5. Effectively address challenging communication issues such as obtaining informed consent, delivering bad news, and addressing anger, confusion and misunderstanding, 5. Convey effective oral and written information about a medical encounter., 5.1. Maintain clear, accurate, and appropriate records (e.g., written or electronic) of clinical encounters and plans, 5.2. Effectively present verbal reports of clinical encounters and plans, 5.3. When appropriate, effectively present medical information to the public or media about a medical issue, Collaborator, 1. Participate effectively and appropriately in an interprofessional healthcare team;, 1.1. Clearly describe their roles and responsibilities to other professionals, 1.2. Describe the roles and responsibilities of other professionals within the health care team, 1.3. Recognize and respect the diversity of roles, responsibilities and competences of other professionals in relation to their own, 1.4. Work with others to assess, plan, provide and integrate care for individual patients (or groups of patients), 1.5. Where appropriate, work with others to assess, plan, provide and review other tasks, such as research problems, educational work, program review or administrative responsibilities, 1.6. Participate effectively in interprofessional team meetings, 1.7. Enter into interdependent relationships with other professions for the provision of quality care, 1.8. Describe the principles of team dynamics, 1.9. Respect team ethics, including confidentiality, resource allocation and professionalism, 1.10. Where appropriate, demonstrate leadership in a healthcare team, 2. Effectively work with other health professionals to prevent, negotiate, and resolve interprofessional conflict., 2.1. Demonstrate a respectful attitude towards other colleagues and members of an interprofessional team, 2.2. Work with other professionals to prevent conflicts, 2.3. Employ collaborative negotiation to resolve conflicts, 2.4. Respect differences, misunderstandings and limitations in other professionals, 2.5. Recognize one’s own differences, misunderstanding and limitations that may contribute to interprofessional tension, 2.6. Reflect on interprofessional team function, Manager, 1. Participate in activities that contribute to the effectiveness of their healthcare organizations and system;, 1.1. Work collaboratively with others in their organizations, 1.2. Participate in systemic quality process evaluation and improvement, such as patient safety initiatives, 1.3. Describe the structure and function of the healthcare system as it relates to their specialty, including the roles of physicians, 1.4. Describe principles of healthcare financing, including physician remuneration, budgeting and organizational funding, 2. Manage their practice and career effectively;, 2.1. Set priorities and manage time to balance patient care, practice requirements, outside activities and personal life, 2.2. Manage a practice including finances and human resources, 2.3. Implement processes to ensure personal practice improvement, 2.4. Employ information technology appropriately for patient care, 3. Allocate finite healthcare resources appropriately;, 3.1. Recognize the importance of just allocation of healthcare resources, balancing effectiveness, efficiency and access with optimal patient care, 3.2. Apply evidence and management processes for cost-appropriate care, 4. Serve in administration and leadership roles, as appropriate., 4.1. Chair or participate effectively in committees and meetings, 4.2. Lead or implement a change in health care, 4.3. Plan relevant elements of health care delivery (e.g., work schedules), Heath Advocate, 1. Respond to individual patient health needs and issues as part of patient care;, 1.1. Identify the health needs of an individual patient, 1.2. Identify opportunities for advocacy, health promotion and disease prevention with individuals to whom they provide care, 2. Respond to the health needs of the communities that they serve;, 2.1. Describe the practice communities that they serve, 2.2. Identify opportunities for advocacy, health promotion and disease prevention in the communities that they serve, and respond appropriately, 2.3. Appreciate the possibility of competing interests between the communities served and other populations, 3. Identify the determinants of health of the populations that they serve;, 3.1. Identify the determinants of health of the populations, including barriers to access to care and resources, 3.2. Identify vulnerable or marginalized populations within those served and respond appropriately, 4. Promote the health of individual patients, communities and populations., 4.1. Describe an approach to implementing a change in a determinant of health of the populations they serve, 4.2. Describe how public policy impacts on the health of the populations served, 4.3. Identify points of influence in the healthcare system and its structure, 4.4. Describe the ethical and professional issues inherent in health advocacy, including altruism, social justice, autonomy, integrity and idealism, 4.5. Appreciate the possibility of conflict inherent in their role as a health advocate for a patient or community with that of manager or gatekeeper, 4.6. Describe the role of the medical profession in advocating collectively for health and patient safety, Scholar, 1. Maintain and enhance professional activities through ongoing learning;, 1.1. Describe the principles of maintenance of competence, 1.2. Describe the principles and strategies for implementing a personal knowledge management system, 1.3. Recognize and reflect learning issues in practice, 1.4. Conduct a personal practice audit, 1.5. Pose an appropriate learning question, 1.6. Access and interpret the relevant evidence, 1.7. Integrate new learning into practice, 1.8 Evaluate the impact of any change in practice, 1.9 Document the learning process, 2. Critically evaluate information and its sources, and apply this appropriately to practice decisions;, 2.1. Describe the principles of critical appraisal, 2.2. Critically appraise retrieved evidence in order to address a clinical question, 2.3. Integrate critical appraisal conclusions into clinical care, 3. Facilitate the learning of patients, families, students, residents, other health professionals, the public, and others, as appropriate;, 3.1. Describe principles of learning relevant to medical education, 3.2. Collaboratively identify the learning needs and desired learning outcomes of others, 3.3. Select effective teaching strategies and content to facilitate others’ learning, 3.4. Demonstrate an effective lecture or presentation, 3.5. Assess and reflect on a teaching encounter, 3.6. Provide effective feedback, 3.7. Describe the principles of ethics with respect to teaching, 4. Contribute to the creation, dissemination, application, and translation of new medical knowledge and practices., 4.1. Describe the principles of research and scholarly inquiry, 4.2. Describe the principles of research ethics, 4.3. Pose a scholarly question, 4.4. Conduct a systematic search for evidence, 4.5. Select and apply appropriate methods to address the question, 4.6. Appropriately disseminate the findings of a study, Professional, 1. Demonstrate a commitment to their patients, profession, and society through ethical practice;, 1.1. Exhibit appropriate professional behaviors in practice, including honesty, integrity, commitment, compassion, respect and altruism, 1.2. Demonstrate a commitment to delivering the highest quality care and maintenance of competence, 1.3. Recognize and appropriately respond to ethical issues encountered in practice, 1.4. Appropriately manage conflicts of interest, 1.5. Recognize the principles and limits of patient confidentiality as defined by professional practice standards and the law, 1.6. Maintain appropriate relations with patients., 2. Demonstrate a commitment to their patients, profession, and society through participation in profession-led regulation;, 2.1. Appreciate the professional, legal and ethical codes of practice, 2.2. Fulfill the regulatory and legal obligations required of current practice, 2.3. Demonstrate accountability to professional regulatory bodies, 2.4. Recognize and respond to others’ unprofessional behaviours in practice, 2.5. Participate in peer review, 3. Demonstrate a commitment to physician health and sustainable practice., 3.1. Balance personal and professional priorities to ensure personal health and a sustainable practice, 3.2. Strive to heighten personal and professional awareness and insight, 3.3. Recognize other professionals in need and respond appropriately
Hyperlinked to another map
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.
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
Unless specified, contents of this map are from "Teaching and Learning Communication Skills in Medicine" by Kurtz, Silverman, Draper.
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.
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, Establishing initial rapport, 1. Greets patient and obtains patient’s name, 2. Introduces self, role and nature of interview; obtains consent if necessary, 3. Demonstrates respect and interest, attends to patient’s physical comfort, Identifying the reason(s) for the consultation, 4. Identifies the patient’s problems or the issues that the patient wishes to address with appropriate opening question (e.g. “What problems brought you to the hospital?” or “What would you like to discuss today?” or “What questions did you hope to get answered today?”), 5. Listens attentively to the patient’s opening statement, without interrupting or directing patient’s response, 6. Confirms list and screens for further problems (e.g. “so that’s headaches and tiredness, anything else?”), 7. Negotiates agenda taking both patient’s and physician’s needs into account, GATHERING INFORMATION, Exploration of patient’s problems, 8. Encourages patient to tell the story of the problem(s) from when first started to the present in own words (clarifying reason for presenting now), 9. Uses open and closed questioning techniques, appropriately moving from open to closed, 10. Listens attentively, allowing patient to complete statements without interruption and leaving space for patient to think before answering or go on after pausing, 11. Facilitates patient's responses verbally and non–verbally e.g. use of encouragement, silence, repetition, paraphrasing, interpretation, 12. Picks up verbal and non–verbal cues (body language, speech, facial expression, affect); checks out and acknowledges as appropriate, 13.Clarifies patient’s statements that are unclear or need amplification (e.g. “Could you explain what you mean by light headed"), 14. Periodically summarises to verify own understanding of what the patient has said; invites patient to correct interpretation or provide further information., 15. Uses concise, easily understood questions and comments, avoids or adequately explains jargon, 16. Establishes dates and sequence of events, Additional skills for understanding the patient’s perspective, 17. Actively determines and appropriately explores:, patient’s ideas (i.e. beliefs re cause), patient’s concerns (i.e. worries) regarding each problem, patient’s expectations: (i.e. goals, what help the patient had expected for each problem), effects: how each problem affects the patient’s life, 18. Encourages patient to express feelings, PROVIDING STRUCTURE TO THE CONSULTATION, Making organisation overt, 19. Summarises at the end of a specific line of inquiry to confirm understanding before moving on to the next section, 20. Progresses from one section to another using signposting, transitional statements; includes rationale for next section, Attending to flow, 21. Structures interview in logical sequence, 22. Attends to timing and keeping interview on task, BUILDING RELATIONSHIP, Using appropriate non-verbal behaviour, 23. Demonstrates appropriate non-verbal behaviour, eye contact, facial expression, posture, position &movement, vocal cues e.g. rate, volume, intonation, 24. If reads, writes notes or uses computer, does in a manner that does not interfere with dialogue or rapport, 25. Demonstrates appropriate confidence, Developing rapport, 26. Accepts legitimacy of patient’s views and feelings; is not judgmental, 27. Uses empathy to communicate understanding and appreciation of the patient’s feelings or predicament, overtly acknowledges patient's views and feelings, 28. Provides support: expresses concern, understanding, willingness to help; acknowledges coping efforts and appropriate self care; offers partnership, 29. Deals sensitively with embarrassing and disturbing topics and physical pain, including when associated with physical examination, Involving the patient, 30. Shares thinking with patient to encourage patient’s involvement (e.g. “What I’m thinking now is.......”), 31. Explains rationale for questions or parts of physical examination that could appear to be non-sequiturs, 32. During physical examination, explains process, asks permission, EXPLANATION AND PLANNING, Providing the correct amount and type of information, Aims: to give comprehensive and appropriate information to assess each individual patient’s information needs to neither restrict or overload, 33. Chunks and checks: gives information in assimilatable chunks, checks for understanding, uses patient’s response as a guide to how to proceed, 34. Assesses patient’s starting point: asks for patient’s prior knowledge early on when giving information, discovers extent of patient’s wish for information, 35. Asks patients what other information would be helpful e.g. aetiology, prognosis, 36. Gives explanation at appropriate times: avoids giving advice, information or reassurance prematurely, Aiding accurate recall and understanding, Aims: to make information easier for the patient to remember and understand, 37. Organises explanation: divides into discrete sections, develops a logical sequence, 38. Uses explicit categorisation or signposting (e.g. “There are three important things that I would like to discuss. 1st...” “Now, shall we move on to.."), 39. Uses repetition and summarising to reinforce information, 40. Uses concise, easily understood language, avoids or explains jargon, 41. Uses visual methods of conveying information: diagrams, models, written information and instructions, 42. Checks patient’s understanding of information given (or plans made): e.g. by asking patient to restate in own words; clarifies as necessary, Achieving a shared understanding: incorporating the patient’s perspective, Aims: to provide explanations and plans that relate to the patient’s perspective to discover the patient’s thoughts and feelings about information given to encourage an interaction rather than one-way transmission, 43. Relates explanations to patient’s perspective: to previously elicited ideas, concerns and expectations, 44. Provides opportunities and encourages patient to contribute: to ask questions, seek clarification or express doubts; responds appropriately, 45. Picks up and responds to verbal and non-verbal cues e.g. patient’s need to contribute information or ask questions, information overload, distress, 46. Elicits patient's beliefs, reactions and feelings re information given, terms used; acknowledges and addresses where necessary, Planning: shared decision making, Aims: to allow patients to understand the decision making process to involve patients in decision making to the level they wish to increase patients’ commitment to plans made, 47. Shares own thinking as appropriate: ideas, thought processes and dilemmas, 48. Involves patient:, - offers suggestions and choices rather than directives, - encourages patient to contribute their own ideas, suggestions, 49. Explores management options, 50. Ascertains level of involvement patient wishes in making the decision at hand, 51. Negotiates a mutually acceptable plan, - signposts own position of equipoise or preference regarding available options, - determines patient’s preferences, 52. Checks with patient, - if accepts plans,, - if concerns have been addressed, CLOSING THE SESSION, Forward planning, 53. Contracts with patient re next steps for patient and physician, 54. Safety nets, explaining possible unexpected outcomes, what to do if plan is not working, when and how to seek help, Ensuring appropriate point of closure, 55. Summarises session briefly and clarifies plan of care, 56. Final check that patient agrees and is comfortable with plan and asks if any corrections, questions or other issues, OPTIONS IN EXPLANATION AND PLANNING (includes content and process skills), IF discussing opinion and significance of problem, 57. Offers opinion of what is going on and names if possible, 58. Reveals rationale for opinion, 59. Explains causation, seriousness, expected outcome, short and long term consequences, 60. Elicits patient’s beliefs, reactions, concerns re opinion, IF negotiating mutual plan of action, 61. Discusses options e.g., no action, investigation, medication or surgery, non-drug treatments (physiotherapy, walking aides, fluids, counselling), preventive measures, 62. Provides information on action or treatment offered: name steps involved, how it works, benefits and advantages, possible side effects, 63. Obtains patient’s view of need for action, perceived benefits, barriers, motivation, 64. Accepts patient’s views, advocates alternative viewpoint as necessary, 65. Elicits patient’s reactions and concerns about plans and treatments including acceptability, 66. Takes patient’s lifestyle, beliefs, cultural background and abilities into consideration, 67. Encourages patient to be involved in implementing plans, to take responsibility and be self-reliant, 68. Asks about patient support systems, discusses other support available, IF discussing investigations and procedures, 69. Provides clear information on procedures, eg, what patient might experience, how patient will be informed of results, 70. Relates procedures to treatment plan: value, purpose, 71. Encourages questions about and discussion of potential anxieties or negative outcomes, Calgary-Cambrdige Guide Communication Content, Patient's Problem List, Exploration of Patient's Problems, Medical Perspective – disease, Sequence of events, Symptom analysis, Relevant systems review, Patient's Perspective - illness, Ideas and beliefs, Concerns, Expectations, Effects on life, Feelings, Background Information - Context, Past Medical History, Drug and Allergy History, Family History, Personal and Social History, Review of Systems, Physical Examination, Differential Diagnosis - Hypotheses, Including both disease and illness issues, Physician's Plan of Management, Investigations, Treatment alternatives, Explanation and Planning with Patient, What the patient has been told, Plan of action negotiated
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
Conceptual framework for systematic communication training, Underlying assumptions, Untitled, Untitled, Untitled, Untitled, Untitled, Untitled, Untitled, Untitled, Untitled, Untitled, Organizational schema for communication programmes, Goals of medical communication, Untitled, Untitled, Untitled, Untitled, Tasks of the medical interview, Borad categories of skills, Principles that characterise effective communication, Focuses of learning and assessment
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, Elderly, Young, Challenged, Low literacy, 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, Formal and informal, Talking within the team and with patients, Healthcare providers in complementary and alternative medicine, Administrators, Researchers, Directly, Through the literature, Making presentations and lectures, Discussion leadership, 5. Communication at a distance, Telephone, Medical records, Written, Computerized, 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, health-related audio/videotapes, CDs, video games, 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
Moodle, Activity Module, Chat, 123FlashChat, Skype Chat, Arsc Chat, Chat Module, Podcasting, ActivityPodcast, iPodcast v37b3, Videoconferencing, Covcell AudioVideo Conferencing Tool, Activity Visioconference Simple 1.0 Beta, Advanced Book, Appointment, Assessments, Assignment Module, Assignment - Oral Assessment, Assignment Rubrics, Choice Module, Covcell Audio Recording Assignment Type, Attendance, Attendance Module, Attendance-chart, Audio, Audio Recorder 1.1 (creates MP3 audio files), Audioconference Module, Presentations, AutoView Presenter, Book, Bookings, Brainstorm, Certificates, Certificate Module, Certificate 4.3 FAT, ChapterTh!sVideo, Course Resume and Start, Covcell Whiteboard, Database Module, DFwiki, Dialogue, Dimdim Web Meeting Activity, Elluminate Live, Block, ActiveUsers, Media, INWICAST Mediacenter, iTunes University Block, Administration, Admin (teacher), Administration Alert, Marking Block, AJAX 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