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

Introductory weekClinical Competence Test

Specialty Clerkship: 8 weeks

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

Setting: Teaching hospital: subspecialty wards, out-patient clinics, developmental paediatrics Network hospitals Community: maternal & child-care centers, private paediatricians

C o n t i n u o u s a s s e s s m e n t

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

basic training

Higher training

Completion of specialist training in paediatrics

Under-graduate

Intern

MRCPCH part I

MRCPCH part II

MRCPCH Clinical

Hong Kong College of Paediatricians Exit Assessment

Resident

Basic training

Knowledge Skills

Attitude

Postgraduate training in Paediatrics

1. Focused history taking

2. Recognize the main issues

3. Knowledge

4. Management plan

1. Conduct of interview

2. Appropriate explanation & negotiation

3. Accuracy of information

Clinical exam

• Conduct of examination

• Technique, interpretation of signs, appropriate confidence

• Discussion: Differential diagnosis

Appropriate investigations

Management plan

Implications for family & child

Basic training

Knowledge Skills

Attitude

Higher training

Postgraduate training in Paediatrics

What differentiates the higher trainee from the basic trainee?

Additional requirements on knowledge, skills and attitudesin 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

Critical appraisal 60 minutes

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

- - - - - - - - - -

Clinical competence Ap

proach to common problems, e.g.

- management of a 29-week premature baby

- status

epilepticus in a 5 year-old girl - worku

p of a 3 year-old boy with recurrent infections

Critical appraisal 60 minutes

Clinical competence (25min)

Critical appraisal (10min)

Examination circuit

- - - - - - - - - -

Service-related issues

How to carry out clinical audit Handling medical errors or drug incidence Supervision of juniors

Service-related issues (10min)

Dissertations (15min)

- - - - - - - - - -

basic training Higher training SpecialistGraduation

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