meu workshop the at–com booklet
TRANSCRIPT
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
“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
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
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
“Today’s culture of medicine is
hostile to altruism, compassion,
integrity, fidelity, and self-
effacement”
Coulehan
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
Faculty development critical
System of evaluation
Professional tone and awareness set
from the top!
Strong institutional support
Case based module
Case scenarios with discussion
points
Structured program
Distributed over all years
? Assessment
Competency Pattern in UG curriculum
Introduce Attitude and Communication Module
Introduce Revised basic course
Share Implementation Plan
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).
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
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
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
Enumerates the roles of the IMG• Clinician
• Leader and member of the core health care
system
• Communicator
• Life long learner
• Professional
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
Number of modules 5 Number of hours 34
Sessions are interdependent Self guided learning Interactive discussions Closure session with reflection Assessment
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
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
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
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