1. Attitude Ethics and Communication AETCOM

2. Graduate Medical Regulations “Indian Medical Graduate” (IMG) possessing requisite knowledge, skills, attitudes, values and responsiveness, so that he or she may function appropriately and effectively as a physician of first contact of the community while being globally relevant

3. Revised Regulations on Graduate Medical Education “Indian Medical Graduate” ROLES Clinician - preventive, promotive, curative, palliative and holistic care with compassion Leader and member of the health care team - collect analyze, synthesize and communicate health data Communicator - patients, families, colleagues and community Lifelong learner - continuous improvement Professional - ethical, responsive and accountable

4. How it is being learnt now? My Teacher Through Hidden curriculum

5. The hidden curriculum The hidden curriculum consists of those things the students learn through the experience of attending college rather than the stated educational objectives of such institutions.

6. PLAN ERED EXPEERIENCED

7. explicit part implicit part

8. Teach by example

9. Attitude- Teaching? Modules Role play Feed Back Project work Fieldtrips Medical camps Voluntary services NCC NSS

10. Movie clips If we could see

11. Attitude, communication Classical approach Vs Direct and explicit teaching What and How to teach? Deriving from participants

12. Attitude and Communication (AT-COM) Module Section I: Extract of goals, roles and universal competencies as envisaged by IMG document. Section II: Suggested teaching modules for each professional year, resources cases and method to teach Section III: List of additional non-core competencies that form a desirable set of learning Section IV: Competency log - in a simulated setting. - progressing in complexity over time.

13. Attitude and Communication (AT-COM) Module Section V: Formative elements that are observable by guide and marked over time. Appendix 1: Set of competencies as approved by the Academic Committee of Medical Council of India Appendix 2: Modified communication skill rating tool adapted from the Kalamazoo consensus

14. Learning modules for Professional year I No. of Modules: 5 N0. of hours: 34 1. What does it mean to be a doctor? BACKGROUND It is important for new entrants to get a holistic view of their profession, its ups and downs, its responsibilities and its privileges. It is important to start this discussion early in their careers when their minds are still fresh with the thrill of joining medical school. Such a discussion will help them remember the big picture through the program and remind them why they have chosen to be doctors

15. Learning modules for Professional year I No. of Modules: 5 N0. of hours: 34 LEARNING EXPERIENCE When: Professional year 1 Hours: 8 (6 hours + 2 hours self directed learning) This session can be delivered by 4 inter-dependent learning experiences

16. Learning modules for Professional year I An exploratory session with the students enquiring from them Why they chose to become doctors and what do they think are the privileges and the responsibilities of the profession. –What do they expect from society and what do they think society expects from them? –What will they have to do and give up in order to meet their own and society's expectations. –This is preferably done in a small group discussion. A facilitated panel discussion involving doctors who are at various stages of their careers (senior, midlevel, young) where doctors share their experiences and also answer questions from students.

17. Learning modules for Professional year I Self directed learning where students write a report from reflection based on sessions 1 & 2 and on other readings, TV series movies etc that they have chosen from the lay press about doctor experiences. Introductory visit to the hospital / community medical centres A closure session with students to share their reflections based on 1, 2, 3 and 4 that includes what they plan to do in the next 5 years in order to fulfill their professional and personal roles as doctors. A white coat ceremony in the Foundation Course. RESOURCES: Whitcomb ME. Academic Medicine 2007 82: 917

19. Communication skill Doctor – Patient / Attendants Applications in Medical Education List the communication skills required to be taught to a UG Derive from participants

20. Doctor – Patient encounter 1. Building the doctor patient relationship 2. Opening the discussion 3. Gathering information 4. Understanding the patient’s perspective 5. Sharing information 6. Reaching agreement on problems and plans

21. Breaking a bad news Goals of the Bad News Interview To provide intelligible information and educate the pt / attendants regarding the disease process To support the patient by employing skills to reduce the emotional impact To develop a strategy in the form of a treatment plan with the input and cooperation of the patient To support the relatives/ attendants in accepting the event

22. SPIKES- Six- Step Protocol for Delivering Bad News Step 1: S- Setting Up The Interview Step 2: P-Assessing the Patient’s Perception Step 3: I –Obtaining the Patient’s Invitation Step 4: K- Giving Knowledge And Information to the Pt. Step 5: E- Addressing the Patient’s emotions With empathic Responses Step 6: S- Strategy and Summary