The document outlines the structure and requirements for implementing an AT-COM module to teach medical professionalism and ethics. It discusses the following key points: 1. The AT-COM module will be introduced in all medical colleges over the next two years as part of the transition to competency-based medical education. 2. It will help define the skills, attitudes, values and responsibilities of an Indian Medical Graduate. 3. The module involves 5 modules totaling 34 hours, covering topics like what it means to be a doctor/patient, the doctor-patient relationship, communication skills, and medical ethics case studies. 4. Formative and summative assessments will be implemented throughout the module.

1. MEU WORKSHOP
The AT – Com Booklet :
Structure, content
and
requirements

5. Socrates: “Tell me: is a doctor in the precise
sense…a money-maker or someone who
treats the sick? Tell me about the one who
is really a doctor.”
Thrasymachus: “He’s the one who treats the
sick.”
Plato, The Republic

6. “A profession…is an occupation that regulates
itself through systematic, required training
and collegial discipline; that has a base in
technical, specialized knowledge; and that
has a service rather than a profit orientation,
enshrined in its code of ethics…”
Starr

7. Ideal Foundational Value Reality
Evidence-based Truth/Science Uncertainty
Caring, healing Curing Risk-harming
Open heart/mind Accepting, Empathetic Arrogant, unmoved
Error-free Right action Mistake-prone
Analytic Reflective Hassled, knee-jerk
Self-sacrificing Altruistic Avaricious

8.  Formal – what we say
 Hidden – what we do

9.  Empathy
 Compassion
 Altruism } What we
say

10.  Most of the critical determinants of
physician identity operate not within
the formal curriculum but in a more
subtle, less officially organized hidden
curriculum
 The hidden curriculum functions at
the level of organizational structure
and culture

11.  Weariness
 Strong distrust of emotions
 Failure of communication

12. “Today’s culture of medicine is
hostile to altruism, compassion,
integrity, fidelity, and self-
effacement”
Coulehan

13.  Current strategy is inadequate
 Production of highly skilled
technicians but not necessarily true
professionals
 Must strike a balance between
explicit teaching and experiential
learning incorporating the values of
professionalism

14.  Faculty development critical
 System of evaluation
 Professional tone and awareness set
from the top!
 Strong institutional support

15.  Cognitive base
 Experiential learning
 Continuity
 Role Modeling
 Mentorship

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

17.  Competency Pattern in UG curriculum
 Introduce Attitude and Communication
Module
 Introduce Revised basic course
 Share Implementation Plan

18. Medical Council is keen on introducing
Competency pattern
 Professionalism – ATCOM module
The contents of the programme include teaching
learning, assessment (formative and summative) as
well as proposed curricular changes (Integrated
teaching, early clinical exposure, internal assessment
and E-learning).

19. Basic course:
 Deliverable: ability to plan and take a good lecture/
practical/bedside teaching
 Challenges: competency based education is being
introduced
 Requirements:
Framing learning objectives from
competencies
Assessment using direct observation methods
Ability to give good feedback

20. Walking through AT-Com:
Teaching AT-Com:
Who
What
When and
How

21.  AT itutde and COM munication module
MCI – Implement the AT-COM module in
all medical colleges across the country
Over next two years
Forerunner of the transition to the
competency based medical education
program envisaged by MCI

22.  Defines ‘Indian Medical Graduate”
(IMG)Possessing
• Requisite knowledge
• Skills
• Attitudes
• Values
• Responsiveness
 Function appropriately and effectively as the
physician of first contact of the community
 While being relevant globally

23. Enumerates the roles of the IMG
• Clinician
• Leader and member of the core health care
system
• Communicator
• Life long learner
• Professional

24.  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

26.  Number of modules 5
 Number of hours 34
 Sessions are interdependent
 Self guided learning
 Interactive discussions
 Closure session with reflection
 Assessment

27. 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

28. Number of modules 7
Number of hours 35

29. 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

30. Number of modules 5
Number of hours 25

31. 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

32. Number of modules
Number of hours 45
The foundation of communication 4

33. 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

35. Additional list of desirable competencies in
attitudes and communications
Non core

37. Suggested log book pattern

39. These may be included in whole or in part
of the formative assessment of the student

41. List of competencies in AT COM
1 – 39 Core competencies
40 -53 non core (Desirable) competencies

42. Communication skills rating scale from
Kalamazoo consensus statement