Relevant Auckland MBChB Learning Outcomes

Clinical Practice: medical graduate as practitioner
2.1: Demonstrate by listening, sharing and responding, the ability to communicate clearly, sensitively and effectively with patients, their family/carers, doctors and other health professionals.
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:
 •  Communicate sensitively and effectively with patients, their families and colleagues using a process of shared decision-making where appropriate;
MBChB 221: Principles of Medicine
 Clinical and Communication Skills
5 •  Discuss how cultural issues along with counselling and ethical principles guide patient care, using examples from clinical genetics.
 Personal and Professional Skills
6Demonstrate the ability to write reflectively on personal and learning experiences.
Be aware of ways in which to support a patient with cancer.
 Hauora Māori
7Discuss considerations for Māori in modern genetic research and clinical practice.
 Population Health
9In a General Practice setting, identify elements of the consultations observed that have relevance to other Learning Outcomes for this course.
MBChB 221: Professional and Clinical Skills 1
 Clinical and Communication Skills
2 •  Describe and discuss the principles and benefits of effective communication
 •  Describe the components of patient-centred interactions
 •  Use appropriate techniques to structure the interview
 •  Use effective communication skills in controlled settings with patients (real or simulated)
3 •  Use a supportive and empathic communication style throughout the assessment & establish rapport
 •  Demonstrate an awareness of non-verbal communication
 Hauora Māori
10 •  Appropriately acknowledge cultural and religious norms during interactions with patients, families and team members
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.
MBChB 221: Cardiovascular System
 Clinical and Communication Skills
7 •  Take a history of a presenting complaint with some medical and social context.
 •  Identify cultural factors and beliefs that influence physical examinations.
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 •  Describe the principles of influencing patient behaviour
 •  Outline strategies used to motivate patients in regard to specific lifestyle modifications
2 •  Describe effective strategies for improving patient adherence
 Clinical and Communication Skills
6The Clinical Relationship
 •  Describe and discuss the principles and benefits of effective communication
 •  Describe the components of patient-centred interactions
 •  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
 •  Describe issues in taking a sensitive history (e.g. sexual history)
 •  Describe strategies for dealing with uncertainty
7Principles of Doctor-Patient Communication
 •  Use appropriate techniques to structure the interview
 •  Describe the elements of a complete clinical history
 •  Describe the elements of effective communication with children
 •  Compare and contrast different models of consultation
 •  Outline principles of using an interpreter
 •  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
8Clinical Assessment: The History and the Physical Examination
 •  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
 •  Develop strategies to close consultations with patients
 Personal and Professional Skills
10 •  Demonstrate an empathetic and professional approach to patients in a real or simulated setting
 Hauora Māori
15 •  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: Anaesthesiology
 Personal and Professional Skills
9 •  Demonstrate the ability to recognise and appreciate the patient’s perspective in clinical situations.
 •  Demonstrate a compassionate approach to patients in clinical settings.
 •  Participate and actively contribute to patient care and other clinical team activities.
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 •  Develop an appropriate management plan for the Māori patient;
 •  Demonstrate skills in negotiating life style changes for patients;
3Explain how and when other health professionals contribute to the care of a patient.
 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;
 •  Admitting to others when you have made a mistake or when you have incomplete knowledge on certain topics;
MBChB 401: Musculoskeletal
 Personal and Professional Skills
8 •  Demonstrate a compassionate approach to patients in clinical settings.
Engagement with the team
 •  Participate and actively contribute to patient care and other clinical team activities.
MBChB 401: General Surgery
 Clinical and Communication Skills
2Evaluate general surgical patients presenting with a range of clinical problems.
 •  Elicit from patients presenting with a given problem, a relevant, logical and comprehensive history;
 •  Develop an appropriate management plan for the Māori patient.
3 •  Examine the respective roles of a multidisciplinary team to provide optimal patient care;
4 •  Examine the respective roles of a multidisciplinary team in peri-operative patient care.
 Personal and Professional Skills
7 •  Demonstrate responsibility, commitment and a reflective attitude to clinical practice.
 •  Identify own limits and seek out additional support or learning opportunities.
 •  Participate and actively contribute to patient care and other clinical team activities.
 •  Identify the strengths and areas for improvement in both your communication and clinical skills when dealing with Māori patients.
 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.
 •  Reflect on own practice and systemic factors in relation to ethnic inequalities.
 •  Identify strategies to overcome barriers with a view to improving Māori health outcomes.
MBChB 401: General Medicine
 Clinical and Communication Skills
2Evaluate medical patients presenting with a range of clinical problems.
 •  Elicit from patients presenting with a given problem, a relevant, logical and comprehensive history;
4 •  Communicate information to patients and families in a clear manner
 •  Examine the respective roles of a multidisciplinary team to provide optimal patient care.
 Personal and Professional Skills
6Work as a constructive and collaborative health care team member, with respect for complementary skills and competencies:
 •  Communicate with patients and other health professionals in a professional manner.
 •  Participate and actively contribute to patient care and other clinical team activities
 •  Demonstrate responsibility, commitment and a reflective attitude to clinical practice;
 •  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 •  Reflect on own practice and systemic factors in relation to ethnic inequalities.
 •  Engage in a culturally safe manner with Māori patients, whānau and communities.
 •  Identify strategies to overcome barriers with a view to improving Māori health outcomes
MBChB 401: Specialty Medicine
 Clinical and Communication Skills
2Evaluate patients presenting with medical problems of the selected specialty.
 •  Elicit from patients presenting with a given problem, a relevant, logical and comprehensive history;
 Personal and Professional Skills
5 •  Communicate with patients and other health professionals in a professional manner.
 •  Participate and actively contribute to patient care and other clinical team activities
MBChB 401: Geriatrics
 Clinical and Communication Skills
2Evaluate older patients presenting with a range of common conditions and problems.
 •  Elicit from patients with multiple medical problems a logical and comprehensive history;
 •  Assess the environmental and social issues that contribute to the medical issues;
 •  Demonstrate respect for and confidence with older people and problems they may face.
3 •  Identify issues specific to Māori patients;
4Explain the multidisciplinary team approach that is used in medical and rehabilitation for the older patient.
 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
 •  Identify actions that health professionals can take to recognise our own biases and reduce their impact.
 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.
 •  Summarise the importance of key stakeholders and community leaders to clinician’s work for health interventions and heath research in communities and countries.
 •  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.
 •  Explain the key principles for discussing end-of-life matters with a dying patient.
 Geriatrics
 •  Explain the problems of communication with patients with cognitive and language (dysphasia) issues and some skills (including how to access help) to overcome these.
 •  Explain the value and contribution of multidisciplinary teams to patient care for older patients and those undergoing rehabilitation.
 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.
MBChB 501: Obstetrics & Gynaecology
 Clinical and Communication Skills
6 •  Use appropriate communication skills during all stages of the examination;
8 •  Communicate with patients and families with respect and cultural sensitivity
 Personal and Professional Skills
9 •  Demonstrate appropriate attitudes and skills in managing obstetric and gynaecologic patients and families.
 •  Demonstrate ethical decision making including obtaining appropriate consent from patients and families.
 •  Maintain appropriate boundaries in the workplace with patients, families and colleagues.
10 •  Work as part of a team including with allied health, other health professionals and recognising the role of community organisations.
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).
 •  Obtain family, social, developmental and immunisation history.
4 •  Outline the requirements for gaining parental consent.
 •  Communicate information to families in a clear manner.
 Personal and Professional Skills
5 •  Demonstrate appropriate attitudes and skills in managing newborns, children, adolescents and their families.
 •  Use ethical decision making including obtaining appropriate consent from families.
6 •  Work as part of a team including with allied health, other health professionals and recognising the role of community organisations.
 Hauora Māori
10 •  Engage appropriately in interactions with Māori individuals, whānau and communities identifying strengths.
MBChB 501: Psychiatry
 Clinical and Communication Skills
4 •  Communicate with patients and families using a clear and sensitive approach.
 Personal and Professional Skills
6 •  Work as part of a team including with allied staff from the multidisciplinary team from the public, community and non-governmental sectors.
 •  Demonstrate a constructive approach in collaborative working environments.
 Population Health
11 •  Appraise the importance of the family and wider environment on the patient.
MBChB 501: Specialty Surgery
 Clinical and Communication Skills
2 •  Elicit from patients presenting with a given problem, a relevant, logical and comprehensive history;
MBChB 501: Formal Learning Yr 5
 Clinical Challenges in Medical Practice
 •  Explain how failings of the biomedical model may relate to problems in the doctor-patient relationship, and how these may be recognised in clinical practice
 Infections and Immunisations in Children
 •  Apply the differences in communication with parents and caregivers in paediatric history
 Interpersonal Violence
 •  Explain the steps needed to be a champion with colleagues and within practice settings
 Prescription Drug Abuse
 •  Design a graduated withdrawal process for a selected patient
 Dilemmas in Palliative Medicine
 •  Apply best practice to respond to difficult questions from people nearing the end of life
 Professionalism in Practice and the PPS Portfolio Made Easy
 •  Demonstrate self-awareness, awareness of impact on others
 Effective interventions for young people
 •  Outline the key features of effective interventions for young people
 •  Summarise the key attributes for effective communication following a clinician demonstration of interviewing a young person and their whanau
 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 Medicine
 Clinical and Communication Skills
 •  Comprehensive patient assessments are conducted for common general medical problems including relevant, logical and comprehensive histories.
 Personal and Professional Skills
 •  Responsibility for decision making at appropriate levels is developed, while recognising the need for assistance.
 •  Ability to work within a multidisciplinary environment is developed.
 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
 Clinical and Communication Skills
 •  Specifically concentrate on taking histories and performing sensitive examinations, using correct techniques and appropriate communication.
 Personal and Professional Skills
 •  Collaboration with patients and other team members and respect for each other’s skill set.
MBChB 551: Paediatrics
 Clinical and Communication Skills
 •  Communication with patients and families.
 •  Participate in patient/carer education e.g. asthma action plans and immunisation.
 Personal and Professional Skills
 •  Participation in handover and the use of structured tools for safe transfer of clinical cases.
MBChB 551: Psychiatry
 Clinical and Communication Skills
 •  Specific emphasis on thorough history taking, mental state examination and risk assessment for patients across the lifespan with various common psychiatric disorders.
 •  Empathetic explanations given in layman’s term.
MBChB 551: General Surgery
 Personal and Professional Skills
 •  Key factors in the continuity of patient care are demonstrated (preoperative, operative, postoperative and discharge).
MBChB 551: Emergency Medicine
 Personal and Professional Skills
 •  Interactions with all healthcare professions occur effectively, especially with emergency ambulance officers.
 Hauora Māori
 •  Involvement of whānau and patients is incorporated in decisions about recommended management plans.
MBChB 551: Clinical Imaging
 Personal and Professional Skills
 •  Participate and actively contribute to multidisciplinary team discussions to improve patient care.