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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. Competencies & Assessment Strategies. Undergraduate Postgraduate. Undergraduate Medical Curriculum at HKU.
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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
Competencies & Assessment Strategies • Undergraduate • Postgraduate
Undergraduate Medical Curriculum at HKU Medicine, Surgery, Paediatrics, O&G, Family medicine / orthopaedics, Psychiatry / Emergency medicine
Undergraduate Medical Education in Paediatrics Specialty Clerkship: 8 weeks Clinical Competence Test Introductory week C o n t i n u o u s a s s e s s m e n t Setting: Teaching hospital: subspecialty wards, out-patient clinics, developmental paediatrics Network hospitals Community: maternal & child-care centers, private paediatricians • 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
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
Objective Structured Clinical Examinations (OSCE) Cardiovascular system General exam / Respiratory system Neurology / Developmental Paediatrics General/ Abdominal exam
MRCPCH part I MRCPCH part II Hong Kong College of Paediatricians Exit Assessment MRCPCH Clinical basic training Higher training Completion of specialist training in paediatrics Under-graduate Intern Resident
Postgraduate training in Paediatrics Knowledge Skills Basic training Attitude
Clinical exam • Conduct of examination • Technique, interpretation of signs, appropriate confidence • Discussion: Differential diagnosis • Appropriate investigations • Management plan • Implications for family & child • Conduct of interview • Appropriate explanation & negotiation • Accuracy of information • Focused history taking • Recognize the main issues • Knowledge • Management plan
Postgraduate training in Paediatrics Knowledge Skills Basic training Higher training Attitude
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
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
Examination circuit Critical appraisal 60 minutes
Clinical competence (25min) Critical appraisal (10min) Examination circuit Critical appraisal 60 minutes - - - - - - - - - -
Clinical competence (25min) Critical appraisal (10min) Examination circuit Critical appraisal 60 minutes - - - - - - - - - - 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
Clinical competence (25min) Critical appraisal (10min) Examination circuit Critical appraisal 60 minutes - - - - - - - - - - Service-related issues (10min) Dissertations (15min) Service-related issues How to carry out clinical audit Handling medical errors or drug incidence Supervision of juniors - - - - - - - - - -
Graduation basic training Higher training Specialist 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