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
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
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
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
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