Attitude Ethics and communication are most important aspects of medical profession.

1. AETCOM Introduction
Dr Devender
MAMC

2. Definition of Profession
• An occupation
– that regulates itself through systematics, required
training and collegial discipline
• That has a base in technical, specialized
knowledge & skills
• That has a service rather than a profit
orientation
• Enshrined in its code of ethics

3. Curriculum Gap
Intended Curriculum
What we student to acquire
Taught Curriculum
Engage student with intended
curriculum
Experienced Curriculum
Differs from student to student
Assessed Curriculum
Assessing what we want them to
learn
Achieved Curriculum
Competencies students acquired
after undergoing course

4.  Formal – what we say
 Hidden – what we do
Curriculum

5. FORMAL CURRICULUM
 Empathy
 Compassion
 Altruism
} What we
say

6. Hidden curriculum (Today)
 Weariness
 Strong distrust of emotions
 Failure of communication

7. IMG – Core Competencies
Professional Life Long Learner
Clinician
LeaderCommunicator

8. Alignment of Skill to Values
Knowledge Skill
Attitude
Values
Indian Medical Graduate

9. Classical Approach
• Role modelling
• Mentorship
• Professional apprenticeship

10. Direct Approach to Teach
• Domains of attitude and communication
• Emphasis on Ethics
• Stage appropriate opportunity for experiential
learning and reflection

11. ATCOM Module
 Case based module
 Case scenarios with discussion points
 Structured program
 Distributed over all years
 ? Assessment

12. AETCOM Module
• 5 Sections
• 2 Annexures

13. Walking through AETCom
Teaching AETCom:
• Who
• What
• When and
• How

14. Section I
• Enumerates the roles of the IMG
– Clinician
– Leader and member of the core health care
system
– Communicator
– Life long learner
– Professional

15. List the competencies required for the
above roles
• Clinician
• Leader and member of
the core health care
system
• Communicator
• Life long learner
• Professional
• 15 core competencies
• 6 core competencies
• 3 core competencies
• 5 core competencies
• 5 core competencies

16. SECTION II

17. Learning modules
for
Professional year I
• Number of modules 5
• Number of hours 34
• Sessions are interdependent
• Self guided learning
• Interactive discussions
• Closure session with reflection
• Assessment

18. What does it mean to be a
doctor
8 (6 +2 hrs of self directed
learning)
Assessment not required
What does it mean to be a
patient
8 (6 +2 hrs of self directed
learning
Formative assessment –
Written and oral
Summative - SAQ
The doctor patient
relationship
7 hours (5 +2hrs for self
directed learning)
Formative
Summative
Foundation of
communication
7 hours (5 +2hrs for self
directed learning
Formative
Summative may be
deferred
The cadaver as our first
teacher
4 (2+2)hrs Formative
Summative may not be
required

19. Learning modules
for
Professional year -2
• Number of modules 7
• Number of hours 35

20. The foundation of communication – 2
The foundation of bioethics
1. Health care as a right
2. Working in a health care team
3. Bioethics contd - The cover up. Case study on
patient autonomy and decision making
4. Bioethics contd – Life machine.
5. Bioethics contd – Who is the doctor?
6. What does it mean to be family member of
the sick patient

21. Learning module
for
professional year 3
• Number of modules 5
• Number of hours 25

22. Foundation of communication 3
1. Case studies in bioethics – Disclosure of
medical errors
2. Seeking immunity
3. The foundation of communication -4
4. Case study in bioethics - Confidentiality
5. Case study in bioethics – Fiduciary duty

23. Learning modules
for
professional year -4
• Number of modules
• Number of hours 45
• The foundation of communication 4

24. 1. Case study in medical –legal and ethical
situations – Child’s child
2. Case study in medical –legal and ethical
situations - The angry brick kiln owner
3. Case studies in ethics empathy and the doctor
patient relationship
4. Case studies in ethics and the doctor – industry
relationship
5. Case studies in ethics and the doctor – The offer
6. Case studies in ethics and patient autonomy –
The cruel parents
7. Dealing with death

25. Section III
• Additional list of desirable competencies in
attitudes and communications
• Non core

26. Section IV
• Competency Acquisition Log
• Suggested log book pattern

27. SECTION V

28. Desirable competencies of AETCOM
• These may be included in whole or in part of
the formative assessment of the student

29. Appendix I
• List of competencies in AT COM
• 1 – 39 Core competencies
• 40 -53 non core (Desirable) competencies

30. Appendix 2
• Communication skills rating scale from
Kalamazoo consensus statement

31. Assessment of Learning
• Provide feedback to improve learning
• Facilitator observe (facilitates learning)
• Corrective measure (including counseling
initiated) if performance below expected

32. Revitalizing professionalism
 Cognitive base
 Experiential learning
 Continuity
 Role Modeling
 Mentorship

33. Sometimes you put
walls up, not to keep
people out
But to see who cares
enough to break them
down
Socrates