This useful and interesting ppt contains an outline and overview of the components of AETCOM booklet released by MCI

1. GOOD AFTERNOON….

13. REFLECT UPON THE VIDEO
SHOWN

15. AIM OF EMPATHY IN COMMUNICATION
• “The feeling of being deeply understood
reinforces a sense of connectedness
between the practitioner and . . . family…
The aim is for . . . the family to feel heard,
and ultimately, to be respected for his/her
unique perspective and past experiences.”
(Geller, 2012, p. 208)

19. AETCOM MODULE
DR.V.SATHYANARAYANAN M.B.B.S., M.D., ACME.,
PROFESSOR OF PHARMACOLOGY & CORE MEMBER OF MEU
SRM MCH & RC,
KATTANKULATHUR, CHENNAI, INDIA

20. OUTLINE
Why AETCOM…?
What is AETCOM module…?
What does it contain…?
Objectives, Purpose & Mission of AETCOM...
Contents – section I, II, III, IV, V, Appendices – 1 and 2
Summary
Conclusion

21. SPECIFIC LEARNING OBJECTIVES
• AT THE END OF THE SESSION, ALL THE PARTICIPANTS WILL BE ABLE TO
1. Define AETCOM rightly
2. State the objectives of AETCOM Document rightly
3. Describe the purpose of AETCOM module appropriately
4. Enumerate the contents of AETCOM module rightly
5. Demonstrate understanding of the importance of AETCOM module
appropriately
6. Demonstrate the skill of using AETCOM module appropriately

24. The overall goal
of undergraduate
medical
education
program
• To create an “Indian Medical Graduate” (IMG) possessing
requisite knowledge, skills, attitudes, values and
responsiveness,
• so that she or he may function appropriately and
effectively as a physician of first contact of the
community
• while being globally relevant.

25. HOW TO FULFILL?
In order to fulfill this goal,
the IMG must be able to
function appropriately,
ethically and effectively in
her/his roles

26. 5 ROLES OF IMG
1. Clinician
2. Leader and member of the health care team and system
3. Communicator
4. Lifelong learner
5. Professional

27. COMPETENCIES
In order to effectively fulfill the above-
mentioned roles,
the IMG must obtain a set of
competencies at the time of
graduation

30. ALIGNMENT
• In order to ensure that training is in alignment with the goals and competencies,
• Medical Council of India has proposed new teaching learning approaches
including
• a structured longitudinal programme on
• attitude,
• ethics and
• communication.

34. CLASSICAL APPROACH
Role modelling and
mentoring associated
with classical approach
to professional
apprenticeship
has long been a
powerful tool

35. WHY AETCOM ?
Classical approach alone is no longer sufficient for the development of a
medical professional.
The domains of attitude and communications with emphasis on ethics
therefore need to be taught directly and explicitly throughout the
undergraduate curriculum.

38. WHAT IS
AETCOM
MODULE ?
guide to facilitate institutions and
faculty
implementing a longitudinal program
that will help students acquire
necessary competence
in the attitudinal, ethical and
communication domains.
It offers framework of competencies
that students must achieve.

39. AETCOM MODULE
It also offers
approaches to teaching
learning methods.
However, it is a
suggested format and
institutions can develop
their own approaches
to impart these
competencies.

40. OBJECTIVES OF
AETCOM
DOCUMENT
This document is a guide to
facilitate institutions and
faculty in implementing a
longitudinal program that
will help students acquire
necessary competence in the
attitude, ethics and
communication domains.

41. PURPOSE
• is to allow the graduate to function in roles envisaged in the revised Graduate
Medical Education Regulations,2017 (GMR 2017).
• The revised GMR 2017 document creates roles for the graduate that
• goes beyond the traditional knowledge and skill components.
• In particular, it adds four roles – leader and member of the health care team,
communicator, life-long learner and professional –
• which call for learning and skills not addressed by the traditional syllabi.

42. PURPOSE OF
AETCOM
MODULE
• To create an “Indian Medical Graduate” (IMG) with
• • knowledge, skills, attitudes, values and
• responsiveness, to function appropriately and
• effectively as a doctor of first contact in the
• community, while being globally relevant
• To function in Five Major Roles & Responsibilities
• 1. Clinician
• 2. Communicator
• 3. Lifelong learner
• 4. Professional
• 5. Leader / member of the health care team

43. WHAT DOES IT CONTAIN ?

44. AETCOM MODULE - HIGHLIGHTS
Case based
module(small
group teaching)
Case scenarios
with discussion
points
Distributed over
all the years
Total 54
competencies
39 core
competencies
Total 27
modules over 4
years
140 instructional
hours including
SDL

46. CONTENTS

47. SECTION I
contains an extract of
the goals, roles and
universal competencies
as envisaged in the GMR
2017 document.
This is the base
document upon which
all learning in the
undergraduate years
must be based and
lists the final
competencies that all
students must achieve.

48. SECTION II
contains suggested
teaching modules
for each
professional year
including
resources, cases
and methods to
teach

49. SECTION III
contains a list
of additional
non-core
competencies
that form a
desirable set of
learning

50. SECTION IV
is a competency log that contains a list of skills
that may be acquired prior to graduation.
These skills are best imparted in a simulated
setting (usually involving standardized
patients).
They are also best done progressing in
complexity over time.
For example, a skill on communicating
treatment options may be acquired at different
levels of complexities spread over phases
before finally being certified

51. SECTION V
contains formative
elements that are
observable by
tutors/mentors/guides
marked over time with
appropriate feedback
in a non-punitive
fashion.

52. APPENDIX 1
• consists of the entire set of competencies
• as approved by the Academic Committee of the
Medical Council of India.

53. APPENDIX 2
provides a modified
communication skill rating
tool
adapted from the
Kalamazoo consensus.

54. DEFINITIONS
GOAL COMPETENCY OBJECTIVE

55. ACTION VERBS USED

56. EXPLANATION OF THE TERMS

57. DOMAINS OF LEARNING

58. LEVELS OF
COMPETENCY

60. TEACHING
LEARNING
METHODS
RECOMMENDED

63. Hybrid problem-oriented
approach

64. GUIDELINES FOR CASE DISCUSSION
• A hybrid problem-oriented approach is one of the most effective ways for
students to explore the various facets of “real life issues” that will confront
them in their careers.
• In addition to problem solving skills, case discussions promote collaborative
learning, teamwork, reflection and self-directed learning.
• The cases presented in this booklet represent competencies that lend
themselves best to this form of learning.

66. Hybrid problem-oriented approach
1
• Two or more learning sessions are recommended for
each session
• with ample time for self-directed learning
• and other learning activities between each session

67. Hybrid problem-oriented approach
2
• A case is introduced into a small group and the facilitator facilitates a small group
• discussion where,
A. a. initial reactions of the group to the case is obtained
B. b. the underlying ethical, legal and societal principles of the case are elicited
C. c. learning objectives for the case are developed
D. d. learning tasks are assigned for members of the learning groups
E. e. learning resources are identified –
1. The suggested location for such a session is a small group discussion
2. area which requires a small table with seating for 8 - 10 students
3. o Suggested duration for such a session is 1 hour
4. o A board with chalk or marker is also required

68. Hybrid problem-oriented approach - 3
• Learning occurs in between sessions by the learners through
following:
1. Self-directed learning by study of identified learning resources
2. Self-directed learning through study of online learning resources
3. Identification of legal, ethical and social precedents for the
given settings
4. Obtaining opinion from seniors in the profession on their
impressions on the setting

69. Hybrid problem-oriented approach - 4
• Reinforcement of the fundamental concepts underlying the case
can be done through
• a large group learning session (lecture or equivalent) in between
the small group sessions

70. Hybrid problem-oriented approach -5
• In the second session, the small group discussion is focused on closure of the case
• (or the part of the case) for which learning objectives were identified for in the first
• session.
• The facilitators may guide the discussion based on the ethical, legal, societal
• and communication aspects of the case.
• The group discusses the case, based on the learning done in between the session and
• provides suggestions and alternatives on the approach for doctors to follow.
• It must be reiterated that there may not be one correct way to resolve a case.
• The approach will be to allow students to reflect, make a choice and defend
their choice, based on their values and learning.

72. STUDENT NARRATIVE

73. STUDENT
NARRATIVE
The student narrative is a learning method that
focuses on the following skills:
a. Elicit, observe and record data.
b. Reflect on the data at a higher level of thinking
and derive opinions and conclusions.
c. Communicate the observations and conclusions in a
written and verbal form and expand on and defend
the conclusions with colleagues and teachers.
d. Form new experiences and conclusions based on
this discussion.

75. SECTION I

76. SECTION I
Goal of the
undergraduate
medical
education
programme
Roles to fulfill
this goal
Competencies
for fulfilling
these roles
Assessment of
skills related to
Attitude, Ethics
and
Communication

78. ASSESSMENT OF SKILLS RELATED TO AETCOM
Assessment is a vital component of competency-based education.
In addition to making the pass/fail decisions, a very important role of assessment is to provide
feedback to the learner and help him/her to improve learning.
The assessment in AETCOM nodule has been designed with this purpose. The teachers should use this
opportunity to observe the performance and provide feedback based on their observations.
In case a student has demonstrated a performance, which is considered below expectation, corrective
action including counseling should be initiated.
Many of the tools in this module may appear subjective but coupled with the experience of the
assessor, they will serve a very useful purpose.

80. SECTION II

81. Learning modules for Professional year I
Number of
modules: 5
Number of
hours: 34

83. CONTENTS OF EACH MODULE
Background
Competencies
addressed with
levels
Learning
Experience –
year of study,
hours, Contents
Assessment
Resources
Cases for
discussion
Points to be
discussed
Resources

84. Learning modules for Professional year II
Number of
modules: 8
Number of
hours: 37

85. Learning modules for Professional year II
• Module 2.1: The foundations of communication - 2
• Module 2.2 The foundations of bioethics
• Module 2.3: Health care as a right
• Module 2.4: Working in a health care team
• Module 2.5: Bioethics continued – Case studies on patient autonomy and
decision making
• Module 2.6: Bioethics continued: Case studies on autonomy and decision
making
• Module 2.7: Bioethics continued: Case studies on autonomy and decision
making
• Module 2.8: What does it mean to be family member of a sick patient?

86. Module 2.1: The foundations of
communication - 2

87. Learning modules for Professional Year III
Number of
modules: 5
Number of
hours: 25

88. Learning modules for
Professional Year III
Module 3.1: The foundations of
communication – 3
Module 3.2: Case studies in bioethics-
Disclosure of medical errors
Module 3.3: The foundations of
communication – 4
Module 3.4: Case studies in bioethics –
Confidentiality
Module 3.5: Case studies in bioethics -
Fiduciary duty

89. Learning modules for Professional Year IV
Number of
modules: 9
Number of
hours: 44

90. Learning modules for Professional Year IV
Module 4.1: The
foundations of
communication – 5
Module 4.2: Case
studies in medico-
legal and ethical
situations
Module 4.3: Case
studies in medico-
legal and ethical
situations
Module 4.4: Case
studies in ethics
empathy and the
doctor-patient
relationship
Module 4.5: Case
studies in ethics:
the doctor-industry
relationship
Module 4.6: Case
studies in ethics and
the doctor -industry
relationship
Module 4.7: Case
studies in ethics and
patient autonomy
Module 4.8: Dealing
with death
Module 4.9: Medical
Negligence

92. SECTION III

93. SECTION III

94. Competency Acquisition: Suggested
Logbook pattern
SECTION III

95. SECTION IV

96. SECTION IV
Formative Elements to be
marked by Tutor
(Desirable competencies in
attitude, ethics and
communication skills that
may be included in whole
or part of the formative
assessment of the student)

98. APPENDICES

99. Appendix 1
List of competencies in
Attitude, Ethics and
Communication
Competencies from 1 -
39 are core
competencies.
Competencies 40 -54
are non-core
(desirable)
competencies that be
assessed formatively
Additional list of
desirable competencies
in attitude, ethics and
communication but
listed as non-core

100. Appendix 2
Communication skills
rating scale adapted
from Kalamazoo
consensus statement
Rating 1-3 - Poor,
4 -6 Satisfactory,
6 -10 Superior

101. 1. Build A Relationship;
2. Open The Discussion;
3. Gather Information;
4. Understand The Patient’s Perspective;
5. Share Information;
6. Reach Agreement On Problems And Plans
7. Provide Closure
(Makoul, 2001)

102. Communication
skills rating scale
Rating 1-3 - Poor,
4 -6 Satisfactory,
6 -10 Superior
CRITERIA SCORE
A. Builds relationship
B. Opens the discussion
C. Gathers information
D. Understands the patient’s
perspective
E. Shares information
F. Manages flow
Overall rating

103. EXAMPLE

104. AETCOM Module 2.1: The
foundations of
communication - 2

105. Background
Communication is a fundamental
prerequisite of the medical profession
and beside skills is crucial in ensuring
professional success for doctors.
This module continues to provide an
emphasis on effective communication
skills.
During professional year II, the
emphasis is on active listening and
data gathering.

106. Competency
addressed
Level: SH
The student should be able to:
Demonstrate ability to communicate
to patients in a patient, respectful,
non-threatening, non- judgmental
and empathetic manner.

107. Learning Experience
Year of study:
Professional
year 2
Hours: 5 (1 + 2
+1+1)
i. Introductory
small group
session - 1 hour
ii. Focused
small group
session - 2 hours
iii. Skills lab
session – 1 hour
iv. Discussion
and closure – 1
hour

108. Contents
• This module includes 3 interdependent learning
sessions:
• 1. Introductory small group session on the
principles of communication with focus on opening
the discussion, listening and gathering data.
• 2. Focused small group session with role play or
videos where the students have an opportunity to
observe, criticise and discuss common mistakes in
opening the discussion, listening and data
gathering.
• 3. Skills lab sessions where students can perform
tasks on standardised or regular patients with
opportunity for self critique, critique by patient
and by the facilitator.

109. Assessment
1. Formative: Participation in
session 2 and performance in
session 3 may be used as part
of formative assessment.
2. Summative: may be
deferred.

110. Resources
1. Makoul G. Essential
elements of communication
in medical encounters: the
Kalamazoo consensus
statement. Acad Med. 2001;
Apr; 76(4): 390-3.
2. Hausberg M. Enhancing
medical students'
communication skills:
development and evaluation
of an undergraduate training
program. BMC Medical
Education 2012; 12:16.

113. SUMMARY
• AETCOM is a COMPETENCY BASED, STRUCTURED LONGITUDINAL
MODULAR PROGRAMME on attitude, ethics & Communication
• It needs to be taught directly and explicitly throughout the
undergraduate curriculum.
• AETCOM module provide background concept, session guidelines
and other resources for these sessions.
• These will be useful for all faculty involved in conducting these
sessions.
• These are conceptual frameworks only .
• Be the torchbearers of this transformational change happening.
• Enhance the quality of community health and patient care in
our country.

115. REFLECTIONS / QUESTIONS