Relevant Auckland MBChB Learning Outcomes

Clinical Practice: medical graduate as practitioner
2.8: Elicit patients’ questions and their views, concerns and preferences, promote rapport, and ensure patients’ full understanding of their problem(s). Involve patients in decision-making and planning their treatment, including communicating risk and benefits of management options.
MBChB Graduate Learning Outcomes
 Clinical and Communication Skills
Graduates will, with a culturally competent, empathetic patient-centred approach and with skills appropriate for the stage and setting of practice:
 •  Competently elicit clear, comprehensive and relevant case histories;
 •  Competently inform and educate patients and their families.
 •  Communicate sensitively and effectively with patients, their families and colleagues using a process of shared decision-making where appropriate;
 Hauora Māori
 •  Engage in a culturally safe manner with Māori individuals, whānau and communities;
MBChB 221: Principles of Medicine
 Hauora Māori
7Discuss considerations for Māori in modern genetic research and clinical practice.
MBChB 221: Professional and Clinical Skills 1
 Clinical and Communication Skills
3 •  Use a supportive and empathic communication style throughout the assessment & establish rapport
 •  Actively explore the patient’s illness experience (i.e. the impact of the illness, their ideas, concerns and expectations)
MBChB 221: Digestive System
 Clinical and Communication Skills
5 •  Take a history of a presenting complaint with some medical and social context.
 •  Identify cultural factors and beliefs that influence physical examinations.
6Describe the principles relating to taking a dietary history and record an individual’s dietary intake.
 Hauora Māori
8 •  Discuss the cultural and social significance of nutrition among Māori.
MBChB 221: Genitourinary System
 Clinical and Communication Skills
3 •  Take a history of a presenting complaint with some medical and social context.
 •  Identify cultural factors and beliefs that influence physical examinations.
 Personal and Professional Skills
7Be aware of own views on having children, possible self-identification with patient, and professional boundaries.
Demonstrate awareness of the possibility of sexual and/or domestic abuse in teenage pregnancy.
MBChB 321: Sensory Systems
 Hauora Māori
4Explain why the head is tapu (sacred) in Māori culture and identify similar values in other cultures.
MBChB 321: Professional and Clinical Skills 2
 Applied Science for Medicine
1 •  Demonstrate an understanding of Medically Unexplained Symptoms and the challenges of treating patients with MUS
 •  Describe the principles of influencing patient behaviour
 •  Outline strategies used to motivate patients in regard to specific lifestyle modifications
2 •  Describe the psychological processes that influence the recognition and interpretation of symptoms
 •  Describe effective strategies for improving patient adherence
 •  Describe factors that can influence the “placebo effect”
 Clinical and Communication Skills
6 •  Describe the components of patient-centred interactions
 •  Outline importance of setting boundaries in various situations
 •  Describe issues in taking a sensitive history (e.g. sexual history)
7 •  Use appropriate techniques to structure the interview
 •  Use effective communication skills in controlled settings with patients (real or simulated)
 •  Compare and contrast the use of a patient-centred or doctor-centred approach
8 •  Explain the rationale for the planned assessment and seek their consent
 •  Use a supportive and empathic communication style throughout the assessment & establish rapport
 •  Actively explore the patient’s illness experience (i.e. the impact of the illness, their ideas, concerns and expectations)
 •  Demonstrate an awareness of non-verbal communication
 Personal and Professional Skills
10 •  Demonstrate an empathetic and professional approach to patients in a real or simulated setting
 •  Discuss professional practice issues relating to power, hierarchy, vulnerability and conflict of interest.
13 •  Critically reflect on own and other cultural and religious norms and how they affect interactions with patients and team members
 Hauora Māori
15 •  Discuss cultural competency in regard to communicating with people from a culture other than one’s own
 •  Adapt communication approaches as and where appropriate to account for cultural differences in patients, families and in healthcare
 Population Health
16 •  Describe the factors that influence the effectiveness of patient education
MBChB 401: Emergency Medicine
 Clinical and Communication Skills
4Communication with patients and families (Also Engagement in team)
5Communicate compassionately and effectively with patients, families and caretakers – listening well, guarding confidences, and respecting their views and cultural differences.
 •  Elicit appropriate, relevant, and focused historical information from patients, families, EMS, nurses and other sources where appropriate;
 •  Use translators and translation services as appropriate.
MBChB 401: General Practice
 Clinical and Communication Skills
2 •  Demonstrate skills in negotiating life style changes for patients;
 Personal and Professional Skills
4 •  Listening and talking with patients and colleagues;
 •  Respecting the strengths and weaknesses of views different from your own while maintaining personal integrity;
 Hauora Māori
6 •  Engage in a culturally safe manner with Māori patients, whānau and communities.
MBChB 401: Musculoskeletal
 Personal and Professional Skills
8 •  Demonstrate a compassionate approach to patients in clinical settings.
 •  Identify the strengths and areas for improvement in both your communication and clinical skills when dealing with Māori patients.
MBChB 401: General Surgery
 Clinical and Communication Skills
4 •  Describe the principles for informed consent;
 Hauora Māori
8 •  Recognise particular issues for Māori with respect to tissue removal and general anaesthesia.
 •  Engage in a culturally safe manner with Māori patients, whānau and communities.
MBChB 401: General Medicine
 Clinical and Communication Skills
4 •  Communicate information to patients and families in a clear manner
 •  Identify and discuss areas of controversy in patient management;
 Personal and Professional Skills
6 •  Communicate with patients and other health professionals in a professional manner.
 •  Participate and actively contribute to patient care and other clinical team activities
 •  Practise ethically and with regard to medico-legal obligations;
 •  Identify the strengths and areas for improvement in both your communication and clinical skills when dealing with Māori patients.*
 •  Maintain appropriate boundaries with patients and other team members.
 Hauora Māori
7 •  Engage in a culturally safe manner with Māori patients, whānau and communities.
MBChB 401: Geriatrics
 Clinical and Communication Skills
2 •  Demonstrate respect for and confidence with older people and problems they may face.
3 •  Identify issues specific to Māori patients;
 •  Identify and discuss areas of controversy in patient management.
 Personal and Professional Skills
6 •  Develop respect for patient autonomy and rights of the older patient, by acquisition/clarification of knowledge of legal and ethical aspects of care pertaining to older people;
 •  Identify the strengths and areas for improvement in both your communication and clinical skills when dealing with Māori patients.
 Hauora Māori
7 •  Engage in a culturally safe manner with Māori patients, whānau and communities.
 •  Reflect on own practice and systemic factors in relation to ethnic inequalities.
 Population Health
8 •  Identify the patients’ experienced episodes of care in the wider context of the community and the health system.
MBChB 401: Formal Learning Yr 4
 Maori Health
 •  Explain why health professionals in Aotearoa/New Zealand need to understand Māori health, inequalities and associated concepts such as colonisation and racism.
 •  Identify actions that health professionals can take to recognise our own biases and reduce their impact.
 •  Describe the stages of the Hui Process and use these elements in clinical practice.
 Motivational Interventions
 •  Explain the principles of motivational interviewing and the applicability of these to everyday consultations and patient interactions.
 •  Describe the key success factors for motivational interviewing.
 •  Demonstrate the practical application of these principles in future patient communication.
 •  Practice the use motivational interviews to elicit patients' questions and their views, concerns and preferences, promote rapport, and ensure patients' have a full understanding of their problem(s).
 Pacific People’s Health
 •  Explain the key strategies to gain respect and an ability to respond to the cultural context and aspirations of Pacific patients; families and communities.
 •  Apply respectful behaviours, skills and knowledge when working with Patients families and communities.
 ORL
 •  Describe the consequences and complications of the treatments of these conditions by listening to the patients' perspective.
 Palliative Care
 •  Summarise the key messages to use in practice when introducing palliative medicine to a new patient.
 Geriatrics
 •  Apply applicable and practical knowledge of ethical issues (especially for patient autonomy) as they especially apply to older, vulnerable patients.
 •  Explain the problems of communication with patients with cognitive and language (dysphasia) issues and some skills (including how to access help) to overcome these.
 Alcohol and Drugs
 •  Describe how to clinically use the tools to deliver brief advice on alcohol and drug use without implied judgement of a patient.
 •  Identify a range of services available and the appropriate time for a referral of a patient
 Patient Can’t Speak for Themselves
 •  Summarise key points relevant to the respect of Māori patients in the operating room and more generally.
MBChB 501: General Practice
 Clinical and Communication Skills
2 •  Appreciate the impact of psychosocial stress on mental health;
3Develop skills for shared decision making with patients.
 •  Explain the importance of patient goals in achieving the best clinical outcome.
 •  Identify specific patient values with particular attention to practicing in a culturally diverse community.
4 •  Demonstrate skills in negotiating life style changes for patients.
 Personal and Professional Skills
5 •  Demonstrate appropriate attitudes and skills in managing patients and their families.
 •  Demonstrate responsibility, commitment and ability to reflect on your judgement and practice.
6 •  Share patient experiences with a group of colleagues, using self-reflective practice to improve professional skills.
7 •  Recognise own limits in stressful situations and in regard to own knowledge.
 Hauora Māori
8 •  Identify the strengths and areas for improvement in both your communication and clinical skills when dealing with Māori patients and their whānau.
MBChB 501: Obstetrics & Gynaecology
 Clinical and Communication Skills
4 •  Select an effective approach to support a woman who wishes to breastfeed her infant.
8 •  Communicate with patients and families with respect and cultural sensitivity
 Personal and Professional Skills
9 •  Demonstrate ethical decision making including obtaining appropriate consent from patients and families.
MBChB 501: Paediatrics
 Clinical and Communication Skills
2 •  Elicit from caregivers and, if appropriate, from the child or young person presenting, a relevant, logical comprehensive history of presenting problem(s).
 •  Develop an appropriate management plan for the Māori patient and family that is consistent with whānau strengths and resources.
4 •  Outline the requirements for gaining parental consent.
 •  Communicate information to families in a clear manner.
 •  Recognise and respect differences in parenting and family dynamics.
MBChB 501: Psychiatry
 Clinical and Communication Skills
2 •  Develop an appropriate management plan for a Māori patient and family that is consistent with whānau strengths and resources.
4 •  Inform and educate patients and their families.
 •  Communicate with patients and families using a clear and sensitive approach.
 Hauora Māori
10 •  Participate in and observe a whānau meeting while being mindful of health beliefs, customs and cultural practices.
 •  Engage appropriately with Māori individuals, whānau and communities, identifying their strengths.
MBChB 501: Specialty Surgery
 Personal and Professional Skills
6 •  Participate and actively contribute to patient care and other clinical team activities.
MBChB 501: Formal Learning Yr 5
 Complementary Medicine (CAM)
 •  Discuss the place of CAM in the context of contemporary health care in relation to history, patient choice, available evidence and legislation
 •  Include questions about non-orthodox treatment when consulting with patients
 •  Describe an approach to discussing CAM with patients
 Women’s Health
 •  Elicit a clear history from a woman with urinary incontinence; determine the mechanisms and types of incontinence based on anatomy and physiology of the urinary tract; outline available information sources to educate patients about conservative treatment options
 •  Demonstrate respect the complementary knowledge and skills of other team members who together aim to improve the woman's quality of life
 •  Observe the interactions between primary care practitioners and specialists, and identify the importance of the role of each in women's health care
 Interpersonal Violence
 •  Explain how to apply IPV screening as part of health screening
 •  Apply the tools for asking about violence and abuse during clinical assessment and for assessing for risk
 Dilemmas in Palliative Medicine
 •  Apply best practice to respond to difficult questions from people nearing the end of life
 Effective interventions for young people
 •  Summarise the key attributes for effective communication following a clinician demonstration of interviewing a young person and their whanau
 •  Explain the importance of working in multidisciplinary teams
 Hauora Māori
 •  Explain the importance of a whānau-centred approach to Māori health
 •  Develop a better understanding of own role in addressing Māori health
MBChB 551: General Practice
 Clinical and Communication Skills
 •  Skills for dealing with medical uncertainty are demonstrated.
 •  Skills in working with distressed patients of all ages and ethnicities are identified, along with those for family and whanau.
 •  Sensitivity discussing diagnoses is demonstrated.
 •  Management plans are culturally appropriate.
 Applied Science for Medicine
 •  Medical, social and psychological principles are incorporated in the GP consultation.
MBChB 551: General Medicine
 Clinical and Communication Skills
 •  Patient centred management plans are prepared for common general medical problems.
 Hauora Māori
 •  Potential bias in working with Māori patients and whānau is identified and strategies are used to overcome biases.
MBChB 551: Obstetrics and Gynaecology
 Personal and Professional Skills
 •  Collaboration with patients and other team members and respect for each other’s skill set.
 Hauora Māori
 •  Consideration of Māori customary practices associated with pregnancy and childbirth in the context of patient- and whānau-centred approaches to care.
MBChB 551: Paediatrics
 Clinical and Communication Skills
 •  Communication with patients and families.
 •  Practice gaining consent from guardians and the patient.
MBChB 551: Psychiatry
 Clinical and Communication Skills
 •  Empathetic explanations given in layman’s term.
MBChB 551: Clinical Imaging
 Clinical and Communication Skills
 •  Communication with patients (both benefits and risks) of what radiological procedures entail.