Competencies and
Assessment Strategies
Prof Yu-Lung Lau & Dr. Pamela Lee
Department of Paediatrics and Adolescent Medicine...
Competencies & Assessment Strategies
• Undergraduate
• Postgraduate
Undergraduate Medical Curriculum at HKU
Medicine, Surgery, Paediatrics, O&G,
Family medicine / orthopaedics,
Psychiatry / ...
Undergraduate Medical Education in Paediatrics
Introductory week
Clinical
Competence Test
Specialty Clerkship: 8 weeks
Act...
End-of-Clerkship Clinical Competency Test
Part I
Direct observation of
history taking by two
examiners, followed by
Q&A
Pa...
Objective Structured Clinical Examinations (OSCE)
Cardiovascular
system
General exam /
Respiratory system
Neurology /
Deve...
basic
training
Higher
training
Completion
of specialist
training in
paediatrics
Under-
graduate
Intern
MRCPCH
part I
MRCPC...
Basic training
Knowledge Skills
Attitude
Postgraduate training in Paediatrics
1. Focused history
taking
2. Recognize the
main issues
3. Knowledge
4. Management
plan
1. Conduct of
interview
2. Appropri...
Basic training
Knowledge Skills
Attitude
Higher training
Postgraduate training in Paediatrics
What differentiates the higher trainee
from the basic trainee?
Additional requirements on knowledge, skills and attitudes
...
Hong Kong College of Paediatricians –
Exit Assessment
I. Dissertations
- Research project / study
- Case report and review...
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Critical appraisal
60 minutes
Examination circuit
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Critical appraisal
60 minutes
Clinical competence
(25min)
Critical appraisal
(10min)
Examin...
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Critical appraisal
60 minutes
Clinical competence
(25min)
Critical appraisal
(10min)
Examin...
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Critical appraisal
60 minutes
Clinical competence
(25min)
Critical appraisal
(10min)
Examin...
basic training Higher training SpecialistGraduation
Knowledge-based
Demonstration of
‘correct’ process
General approach
Ho...
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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
  • Competencies and Assessment Strategies by Prof Yu-Lung Lau ...

    1. 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. 2. Competencies & Assessment Strategies • Undergraduate • Postgraduate
    3. 3. Undergraduate Medical Curriculum at HKU Medicine, Surgery, Paediatrics, O&G, Family medicine / orthopaedics, Psychiatry / Emergency medicine
    4. 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. 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. 6. Objective Structured Clinical Examinations (OSCE) Cardiovascular system General exam / Respiratory system Neurology / Developmental Paediatrics General / Abdominal exam
    7. 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. 8. Basic training Knowledge Skills Attitude Postgraduate training in Paediatrics
    9. 9. 1. Focused history taking 2. Recognize the main issues 3. Knowledge 4. Management plan 1. Conduct of interview 2. Appropriate explanation & negotiation 3. 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. 10. Basic training Knowledge Skills Attitude Higher training Postgraduate training in Paediatrics
    11. 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. 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. 13.            Critical appraisal 60 minutes Examination circuit
    14. 14.            Critical appraisal 60 minutes Clinical competence (25min) Critical appraisal (10min) Examination circuit - - - - -- - - - - 
    15. 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. 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. 17. basic training Higher training SpecialistGraduation 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

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