Defining and Maintaining Core David Taylor

In the UK there is little flexibility The GMC have produced two documents The GMC have produced two documents Tomorrow’s Doctors Tomorrow’s Doctors Tomorrow’s Doctors Tomorrow’s Doctors The New Doctor The New Doctor The New Doctor The New Doctor Between them they define what we have to make sure the students know Between them they define what we have to make sure the students know

Our handbook gives a generic syllabus Subject knowledge & understanding Subject knowledge & understanding As ‘core’, students will be able to synthesize, appraise, explain, and apply the relevant information/evidence about: As ‘core’, students will be able to synthesize, appraise, explain, and apply the relevant information/evidence about: the structure and mechanisms of the body in health and disease, from molecules up to the whole organism related to: the structure and mechanisms of the body in health and disease, from molecules up to the whole organism related to: normal and abnormal structure and function of the body and its defence mechanisms; the natural history, symptoms, and signs of disease; and the biological rationale for therapy and the processes underlying its complications normal and abnormal structure and function of the body and its defence mechanisms; the natural history, symptoms, and signs of disease; and the biological rationale for therapy and the processes underlying its complications variability in the role of the determinants of health and disease, the presentation of disease, and the response to therapy variability in the role of the determinants of health and disease, the presentation of disease, and the response to therapy clinical diagnosis and management of common conditions clinical diagnosis and management of common conditions The interrelationships of social, psychological, economic, political, environmental, cultural factors on health and disease The interrelationships of social, psychological, economic, political, environmental, cultural factors on health and disease

Our first step Was to decide which 200 cases a student would need to be familiar with when they graduated Was to decide which 200 cases a student would need to be familiar with when they graduated We finally agreed on about 208 We finally agreed on about 208

Core Cases

Then We decided which cases the students would study through PBL We decided which cases the students would study through PBL

PBL modules

Scenario

Then The students determine the learning objectives in their PBL groups – they can see every groups’ learning objectives The students determine the learning objectives in their PBL groups – they can see every groups’ learning objectives

Learning objectives

Which we examine

Not just knowledge but skills Communicating effectively Communicating effectively Working in a team Working in a team Being aware of limitations Being aware of limitations Understanding disease processes Understanding disease processes Managing time effectively Managing time effectively Developing appropriate attitudes towards personal health and wellbeing Developing appropriate attitudes towards personal health and wellbeing Recognition of social and emotional factors in illness and treatment Recognition of social and emotional factors in illness and treatment

Providing care for people of different cultures Providing care for people of different cultures Coping with uncertainty Coping with uncertainty Making the best use of laboratory and other diagnostic services Making the best use of laboratory and other diagnostic services Using informatics as a tool in medical practice Using informatics as a tool in medical practice Understanding the purpose and practice of audit, peer review and appraisal Understanding the purpose and practice of audit, peer review and appraisal Understanding the relationship between primary and social care and hospital care Understanding the relationship between primary and social care and hospital care Using opportunities for disease prevention and health promotion Using opportunities for disease prevention and health promotion Being aware of legal and ethical issues Being aware of legal and ethical issues

Understanding the principles of evidence- based medicine Understanding the principles of evidence- based medicine Diagnosis, decision making and the provision of treatment including prescribing Diagnosis, decision making and the provision of treatment including prescribing Keeping accurate records Keeping accurate records Obtaining valid consent Obtaining valid consent Calculating accurate drug dosages Calculating accurate drug dosages Writing a prescription Writing a prescription

Venepuncture Venepuncture Arterial blood sampling Arterial blood sampling Suturing Suturing Performing an electrocardiogram Performing an electrocardiogram Basic cardiopulmonary resuscitation Basic cardiopulmonary resuscitation Administering oxygen therapy safely Administering oxygen therapy safely Correctly using a nebulizer Correctly using a nebulizer Inserting a nasogastric tube Inserting a nasogastric tube Urinary catheterization Urinary catheterization Control of haemorrhage Control of haemorrhage

Each year We review the cases in the light of the learning objectives the students are obtaining We review the cases in the light of the learning objectives the students are obtaining And the examination results And the examination results And we review the content of one of the four subject themes And we review the content of one of the four subject themes S&F, IGS, PP, PPD S&F, IGS, PP, PPD