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 week Clinical 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 KnowledgeSkills 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 KnowledgeSkills Attitude Higher training Postgraduate training in Paediatrics

What differentiates the higher trainee from the basic trainee? Additional requirements on knowledge, skills and attitudes in 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 Approach to common problems, e.g. - management of a 29-week premature baby - status epilepticus in a 5 year-old girl - workup 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 trainingHigher training Specialist Graduation 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