Relevant Auckland MBChB Learning Outcomes

Clinical Practice: medical graduate as practitioner
2.13: Describe the principles of care for patients at the end of their lives, avoiding unnecessary investigations or treatment, and ensuring physical comfort including pain relief, psychosocial support and other components of palliative care.
MBChB Graduate Learning Outcomes
 Applied Science for Medicine
 •  Discuss the normal structure, function and development of the human body and mind at all stages of life, the factors that may disturb these, and the interactions between body and mind;
MBChB 221: Principles of Medicine
 Applied Science for Medicine
4 •  Use oncology clinical scenarios as examples of the application of core biomedical knowledge to clinical situations.
MBChB 321: Professional and Clinical Skills 2
 Applied Science for Medicine
4 •  Describe the hospice approach to palliative care for the terminally ill
5 •  Identify the respective roles and responsibilities of the members of a multidisciplinary team in the provision of optimal patient care
 Clinical and Communication Skills
6 •  Outline importance of setting boundaries in various situations
 •  Discuss issues around death and dying and communication techniques used in this context
 •  Describe the principles of delivering bad news
 Personal and Professional Skills
10 •  Demonstrate an empathetic and professional approach to patients in a real or simulated setting
11 •  Discuss ethical and legal principles and issues relating to death and dying
 •  Demonstrate the ability for ethical reasoning about medical dilemmas
12 •  Discuss the importance of self-care and resilience for personal and professional practice
 Hauora Māori
15 •  Outline the cultural differences that affect grief, death and dying
MBChB 401: General Practice
 Clinical and Communication Skills
3 •  Make referrals for specialist advice appropriately for a range of conditions;
MBChB 401: General Surgery
 Clinical and Communication Skills
3 •  Examine the respective roles of a multidisciplinary team to provide optimal patient care;
MBChB 401: Geriatrics
 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;
MBChB 401: Formal Learning Yr 4
 Palliative Care
 •  Summarise the key messages to use in practice when introducing palliative medicine to a new patient.
 •  Explain the key principles for discussing end-of-life matters with a dying patient.
 •  Describe death trajectories and associated practice implications (e.g. sudden death, terminal illness, frailty, organ failure)
 •  Summarise the key messages to convey when communicating with a patient/ whanau about decisions of ‘do not resuscitate’.
 Geriatrics
 •  Explain the value and contribution of multidisciplinary teams to patient care for older patients and those undergoing rehabilitation.
MBChB 401: Palliative Medicine
 Clinical and Communication Skills
 •  Define and explain the concepts of palliative and end of life care; shared care model of working and interface between services.
 •  Explain common ethical dilemmas related to decision-making in an acutely unwell patient with known chronic illness, including those relating to the advantages and disadvantages of investigations, treatment and non-intervention.
 •  Demonstrate important concepts through a formal presentation of a case study of a palliative care patient seen by the student.
MBChB 501: General Practice
 Personal and Professional Skills
6 •  Contribute to the initiation of referrals for specialist advice appropriately for a range of conditions.
7 •  Recognise own limits in stressful situations and in regard to own knowledge.
MBChB 501: Formal Learning Yr 5
 Dilemmas in Palliative Medicine
 •  Improve prescribing practice using opioids, syringe driver medication and also converting oral medications to parenteral and practice
 •  Identify the key skills for triaging referrals in palliative medicine
 •  Apply pain and symptom management in the last days of life
 •  Apply best practice to respond to difficult questions from people nearing the end of life
MBChB 551: General Practice
 Clinical and Communication Skills
 •  Competence is demonstrated in a range of consultations, especially for acute care, long-term conditions, episodic care and palliative care.
 •  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.
 •  Specialist advice is integrated appropriately for a range of conditions.
 Personal and Professional Skills
 •  Competency is developed in transfer of care to medical and other healthcare teams.