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Competencies and Assessment Strategies by Prof Yu-Lung Lau ...

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  • ELABORATE
  • A continuum of medical learning that begins in medical school and continues until the end of a professional career
  • “ competency” as a complex set of behaviors built on the components of knowledge, skills, and attitudes
  • The correct process Ability to identify problems or signs, integration of findings Longer stations, more complex task Mark according to an expected standard: conduct of examination, skills and discussion
  • “ competency” as a complex set of behaviors built on the components of knowledge, skills, and attitudes
  • ORGANIZATION OF PRACTICE DIFFERENTIATE HIGHER FROM BASIC TRAINING BASIC: A BIT MORE ADVANCED THAN MBBS, BUT MORE SPECIFIC, SERVICE ORIENTATED CONTEXT-SPECIFIC Hx taking, specific task MRCPCH circuit Examination checkpoint: a higher level performance / task Developmental paed
  • Continuous assessment vs apprenticeship, ongoing every day The value of the department / unit

Transcript

  • 1. Competencies and Assessment Strategies Prof Yu-Lung Lau & Dr. Pamela Lee Department of Paediatrics and Adolescent Medicine LKS Faculty of Medicine The University of Hong Kong
  • 2. Competencies & Assessment Strategies
    • Undergraduate
    • Postgraduate
  • 3. Undergraduate Medical Curriculum at HKU Medicine, Surgery, Paediatrics, O&G, Family medicine / orthopaedics, Psychiatry / Emergency medicine
  • 4. Undergraduate Medical Education in Paediatrics Introductory week Clinical Competence Test Specialty Clerkship: 8 weeks
    • Activities:
    • Bedside teaching
    • out-patient clinic attachment
    • Service-rounds
    • Professorial rounds
    • Student seminars & workshops
    • Small group tutorials
    • - Departmental grandrounds
    • Medical-social visits and
    • case conferences
    • - Case reports
    • - Web-based teaching
    Setting: Teaching hospital: subspecialty wards, out-patient clinics, developmental paediatrics Network hospitals Community: maternal & child-care centers, private paediatricians C o n t i n u o u s a s s e s s m e n t
  • 5. End-of-Clerkship Clinical Competency Test
    • Part I
    • Direct observation of
    • history taking by two
    • examiners, followed by
    • Q&A
    Part II Counseling : Simulated patient / parent
  • 6. Objective Structured Clinical Examinations (OSCE) Cardiovascular system General exam / Respiratory system Neurology / Developmental Paediatrics General / Abdominal exam
  • 7. basic training Higher training Completion of specialist training in paediatrics Under-graduate Intern MRCPCH part I MRCPCH part II MRCPCH Clinical Hong Kong College of Paediatricians Exit Assessment Resident
  • 8. Basic training Knowledge Skills Attitude Postgraduate training in Paediatrics
  • 9.
    • Focused history taking
    • Recognize the main issues
    • Knowledge
    • Management plan
    • Conduct of interview
    • Appropriate explanation & negotiation
    • Accuracy of information
    • Clinical exam
    • Conduct of examination
    • Technique, interpretation of signs, appropriate confidence
    • Discussion: Differential diagnosis
    • Appropriate investigations
    • Management plan
    • Implications for family & child
  • 10. Basic training Knowledge Skills Attitude Higher training Postgraduate training in Paediatrics
  • 11. What differentiates the higher trainee from the basic trainee?
    • Additional requirements on knowledge, skills and attitudes
    • in higher training:
    • Evidence-based practice, critical appraisal skills
    • Clinical reasoning and decision-making
    • Organization of practice
    • Interest in clinical or basic research
    • Supervision of junior trainees
    • Some subspecialty experience
  • 12. Hong Kong College of Paediatricians – Exit Assessment
    • I. Dissertations
    • Research project / study
    • Case report and review of literature of a clinical problem related to the case
    • II. Clinical Experience / competence
    • Approach to problem formulation and clinical judgment, competence with managing clinical problems
    • III. Service-related issues
    • medico-legal problems, ethical issues, risk management, communication skills, doctor-patient relationship, clinical audit, quality assurance programs, training and supervision of staff etc.
    • IV. Critical appraisal of scientific publication
    • Ability to appraise a paper regarding methodology, evaluation of results and clinical relevance
  • 13.                     Critical appraisal 60 minutes Examination circuit
  • 14.                     Critical appraisal 60 minutes Clinical competence (25min) Critical appraisal (10min) Examination circuit - - - - - - - - - - 
  • 15.                     Critical appraisal 60 minutes Clinical competence (25min) Critical appraisal (10min) Examination circuit - - - - - - - - - - Clinical competence Approach to common problems, e.g. - management of a 29-week premature baby - status epilepticus in a 5 year-old girl - workup of a 3 year-old boy with recurrent infections 
  • 16.                     Critical appraisal 60 minutes Clinical competence (25min) Critical appraisal (10min) Examination circuit - - - - - - - - - - Service-related issues How to carry out clinical audit Handling medical errors or drug incidence Supervision of juniors Service-related issues (10min) Dissertations (15min) - - - - - - - - - -  
  • 17. basic training Higher training Specialist Graduation Knowledge-based Demonstration of ‘ correct’ process General approach Hospital-based Competence-based Problem identification, integration of findings, clinical reasoning Context-specific task Service-orientated Organization of practice Community / developmental paediatrics