Developing a Framework of Competencies for Medical Graduate Outcomes

Final Report

February 2011

Report prepared on behalf of Medical Deans Australia and New Zealand Inc by:

Allan Carmichael Dean, Faculty of Health Science University of Tasmania Professor of Paediatrics & Child Health Medical Science 1 17 Liverpool Street Hobart TAS 7000 Tel: 03 6226 4860 Fax: 03 6226 4862 Email: A.Carmichael@utas.edu.au

Monique Hourn Project Manager Competencies Project Medical Deans Australia and New Zealand Inc Level 6 173 – 175 Philip Street Sydney NSW 2000 Tel: 02 9114 1680 Fax: 02 9114 1722 Email: mhourn@medicaldeans.org.au

Contents Executive Summary............................................................................................................................... 1 Introduction............................................................................................................................................ 3 Scope, methodology and achievements of the project ......................................................................... 4 Future Use and Next Steps ..................................................................................................................12 Conclusion............................................................................................................................................13 Key Outcomes against the Objectives................................................................................................. 14 Appendices.......................................................................................................................................... 16

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EXECUTIVE SUMMARY In 2010, the Australian Government Department of Health and Ageing (DoHA) provided funding to Medical Deans Australia and New Zealand Inc (Medical Deans) to document competencies for the medical graduate outcomes required by the Australian Medical Council (AMC), and which depend on clinical placements. The AMC’s forty attributes for medical graduates provided the anchor point for the project. The project evolved from priorities identified from the National Clinical Training Review1 prepared by Medical Deans for the Medical Training Review Panel in 2008. That Review confirmed that medical education faced significant pressures to be able to continue to provide quality clinical training places for the current and projected number of medical students. This current work, translating the AMC forty attributes into a framework of competencies has helped to quantify the learning that occurs in a quality clinical placement and thus will assist in addressing the pressures of increased medical student numbers. The project has been a resounding success. Thirty of the AMC graduate attributes have been successfully delineated into Student Learning Outcomes and then competencies which rely on clinical placements to produce a Framework of Competencies for Medical Graduate Outcomes. The Framework has been endorsed by key stakeholders in medical education in Australia. It has provided a platform to bring key people together in medical education to discuss clinical placements and to provide transparency regarding the learning which occurs in a clinical environment. The key outcomes of the project include:

• defining the current competence – based medical education environment • the development of the Attributes Spectrum • the use of Student Learning Outcomes in the delineation process • the development of an interactive framework utilising eight common clinical rotations identified

in the National Clinical Training Review report • the introduction of lists of common procedural and diagnostic skills • extensive stakeholder consultation • delineation of thirty out of the 40forty AMC attributes into Student Learning Outcomes and

then competencies which rely on clinical placements

Substantial research was conducted on competency frameworks, reports, related projects and competency based education occurring in medical schools. The project has relied on two key findings from this research: - the release of a new definition of competence/competency by the International Competence –

Based Medical Education Collaborators in 2010; and

- the concept of tacit and codified knowledge as explored in the Australian Medical Council’s Consultation Paper on Competence – Based Medical Education in August 20102.

1 Medical Deans, National Clinical Training Review Report to the Medical Training Review Panel, Clinical Training Sub-Committee, February 2008. 2 Australian Medical Council, Competence - Based Medical Education, AMC Consultation Paper , August 2010

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The introduction of the Attributes Spectrum was a major development for the project. The Attributes Spectrum ranks the AMC graduate attributes according to their degree of reliance on a clinical setting thus allowing for all of the AMC graduate attributes to be developed in a clinical placement. Attributes were ranked in three categories, with those in the red zone, the area designated as predominately acquired in a clinical setting, the initial focus for the delineation process into competencies. Student Learning Outcomes were also introduced to help address the paradigm shift from attributes/statements to an outcomes - based education process. The use of the Student Learning Outcomes as an intermediary step assisted with the identification of competencies which relied on clinical placements. The use of mind mapping software to present the draft framework of competencies was a significant development in conceptualising how the Framework could be presented. The incorporation of the mind mapping enabled the AMC graduate attributes to be mapped to the Student Learning Outcomes, then competencies; and then to the eight common clinical rotations as identified by the National Clinical Training Review Report: Surgery, General Medicine, Obstetrics and Gynaecology, Paediatrics, Mental Health, General Practice, Emergency Medicine/Critical Care and Others. The introduction of lists of common diagnostic and procedural skills has refined the Framework further by aiming to identify the diagnostic and procedural skills which the medical student should have attained on graduation. There has been a progressive consultation with key stakeholders across the medical education continuum to assist with the documentation of the competencies which rely on clinical placements. The consultation process culminated in the convening of these stakeholders at a Consensus Conference, with the main outcomes being:

1. Solid endorsement of the Framework 2. Support for the further development of the lists of common diagnostic and procedural skills for

the medical graduate, specifying the level of achievement for the medical graduate.

3. Strong support for the AMC to review their graduate attributes.

The Framework has now also been endorsed by the Deans as a whole. It will provide a useful resource to assist with the development of new clinical placements or as a resource for evaluating existing clinical placements. Medical Deans is appreciative of the support provided by the Department of Health and Ageing which has ensured that the Competencies Project has developed into a project of importance for medical education.

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Introduction Medical Deans received funding in early 2010 from the Australian Government to develop a framework of competencies for medical graduate outcomes which rely on clinical placements. The objectives of the project were to: 1. Identify the competencies associated with each of the attributes in knowledge, skills and

attitudes/behaviours specified by the AMC for competent medical graduates and which depend on clinical placements.

2. Use the AMC Accreditation Standards and Processes for medical graduates (including International Medical Graduates), the Medical Deans’ National Clinical Training Review report, the Australian Curriculum Framework for Junior Doctors (ACFJD) and any other relevant reports/projects as the basis of the development of a document that maps competencies to AMC prescribed attributes and which enables graduates to practice at the beginning of the PGY1 Year.

3. Ensure engagement of stakeholders in the identification and specification of competencies. 4. Ensure that the competencies documented are appropriate for a graduating medical student to

commence work as an intern in the standard clinical rotations of the intern year (PGY1). 5. Ensure that the competencies enable a graduating medical student to continue to undertake

further learning and clinical training. This report provides a comprehensive account of the manner in which the project was undertaken and the project’s achievements. It also outlines the potential future use of the Framework. A copy of the Framework of Competencies for Medical Graduate Outcomes is attached as a separate document, and a version of the ‘mind mapped’ Framework accompanies this report.

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Background For medical schools, adequate clinical places are necessary to produce graduates who are competent to practice safely and effectively as interns. It is also essential for graduates to have had the appropriate foundation for further training in any branch of medicine, and for this training to allow for continued professional development throughout their career. This has become critical as numbers of medical students increase The Medical Deans’ Competencies Project grew out of the 2007 - 2008 Medical Deans’ National Clinical Training Review which identified the need for sufficient and quality clinical placements in medical education. It was felt that by developing a Framework of Competencies which relies on clinical placements, a level of clarity and precision around the training that occurs in a clinical environment could be devised. Research informing the development of the Framework Current literature was reviewed to assist with the development of the Framework and to determine the competence – based medical education environment. There were three significant reports which influenced the development of the Framework: General Medical Council: Tomorrow’s Doctors3 - an example of an outcomes - based framework implemented in medical education in the United Kingdom. United Kingdom medical schools are now being accredited against this framework. Tomorrow’s Doctors is an example of an outcomes - based framework which is implemented at the medical graduate level. The CanMEDS 2005 Physician Competency Framework4 - a world recognised competency framework for physician competencies. The CanMEDS framework provided insight into the development of, and implementation of, a competency framework at the vocational level of medical education. The Future of Medical Education in Canada (FMEC) report5 - an example of a national outcomes measurement and which includes references to competencies. The FMEC report looked at how the education programs for medical doctors can best respond to societal needs. The release of the FMEC report included ten recommendations for medical education in Canada. Of particular significance was recommendation number nine, the adoption of a competency – based and flexible approach. Of significant importance was the release of the International Competence – Based Medical Education Collaborators new definition of Competence, Competencies and Competency - Based Medical Education. The collaborators conducted a systematic review of the literature on Competency Based Medical Education to develop new definitions. The definitions are:

3 General Medical Council, Tomorrow’s Doctors, September 2009. 4 Frank, JR. (Ed). 2005 The CanMEDS 2005 physician competency framework. Better Standards. Better physicians. Better care. Ottawa: the Royal College of Physicians and Surgeons of Canada. 5 The Association of Faculties of Medicine of Canada, Future of Medical Education in Canada (FMEC), A Collective Vision for MD Education, 2010

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Competency / Competencies - An observable ability of a health professional - Reflects a spectrum - Integrates multiple components such as knowledge, skills, values, and attitudes. - Multiple competencies can be combined - Measureable with respect to a defined outcome

Competency - Based Medical Education

- Is an outcomes - based approach to the design, implementation, assessment and evaluation of a medical education program using an organising framework of competencies.

Competent

- Possessing the required abilities in all domains at a specified stage of medical education or practice.

The Medical Deans’ Competencies Project adopted these definitions when referring to competence, competencies and competency. Of equal importance was the release of the AMC Consultation Paper on Competence – Based Medical Education in August 2010. The AMC internal working party which oversaw this work was chaired by Professor Nicholas Glasgow and also included Professor David Prideaux. Both were members of the Competencies Project Reference Group and Writing Group, enabling a useful sharing of information between the AMC Project and the Competencies Project. The proposed AMC framework makes distinctions between codified knowledge and tacit knowledge. Clinical placements are a combination of codified and tacit knowledge with early clinical experiences comprising mostly codified knowledge. The Reference Group and Medical Deans supported the framework proposed by AMC. This framework has helped to inform the competencies identified which rely on clinical placements. Projects informing the development of the Framework There were a number of key projects being conducted in Australia which had concurrent themes around addressing clinical competence, academic standards and quality and safety. These included the Australian Learning and Teaching Council’s Academic Standards Project for Health, Medicine and Veterinary Science, HWA’s Simulated Learning Environments for Medicine, HWA’s National Health Competency Framework and ACFJD. These related projects helped to inform the development of the Framework, facilitated stakeholder engagement and also provided the conduit for sharing related information. Competency - based education currently in place in medical education A brief review of competence – based education across medical education in Australia revealed that some universities had adopted an outcomes - based approach to curriculum delivery, although there were very few medical schools utilising a competency - based approach. The medical schools at the University of Queensland and the University of Notre Dame were the only two schools identified that have adopted a competency – based approach to sections of their medical curriculum. The most comprehensive demonstration of competence - based education was found at the University of Queensland where a competency - based initiative has been implemented for first year clinical skills sessions using a model of ‘rolling’ assessment. This initiative delivers a highly structured

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clinical coaching program for first year clinical and procedural skills resulting in improved clinical skills for first year medical students. At the prevocational level, most state prevocational medical councils referenced the Australian Curriculum Framework for Junior Doctors (ACFJD) as the educational curriculum for teaching interns. At the vocational level, the majority of colleges have either adopted, or are in the process of transitioning to a CanMEDS style of framework for the delivery of their curriculum. Methodology Initial activities involved the establishment of a Reference Group whose role was to provide strategic advice and direction for the project. The Reference Group was led by Medical Deans with the Chair of the Reference Group Professor Allan Carmichael, previous President of Medical Deans, and the Deputy Chair, Professor Nicholas Glasgow, a member of the Medical Deans’ Executive and the representative for the Australian Medical Council. Other members of the Reference Group represented major stakeholder organisations across the medical education continuum. A full list of members of the Reference Group Membership is included in Appendix A. Early on, it was clear that it would be beneficial for the project to establish a smaller more specialised Writing Group to help with the delineation process and to help achieve the objectives of the project. The Writing Group included members from Medical Deans, Medical Educators, Confederation of Post Graduate Medical Education Councils (CPMEC), Australian Medical Association – Council of Doctors in Training (AMACDIT) and Australian Medical Students Association (AMSA). A full list of Writing Group Membership is included in Appendix A. In order to contain the scope of the project, the Reference Group decided that the project focus on those clinical placements that occur in the second half of a University Medical Program. This is when the students are full time in their clinical rotations. These clinical placements have also been identified as the pressure point in medical education with the increase in student numbers in the future and the challenges of providing a quality clinical placement. Key stages in the development of the Framework Attributes Spectrum One of the first challenges was identifying which of the AMC graduate attributes relied on clinical placements. This lead to the development of the Attributes Spectrum which identifies and ranks attributes according to their degree of reliance on being acquired in a clinical setting. The Reference Group ranked the forty AMC graduate attributes according to their degree of reliance on being acquired in a clinical setting. This important development for the project provided a system to address the major objective of the project. The Attributes Spectrum also identified a starting point for the delineation process. The delineation process involved translating those attributes which relied on clinical placements, into Student Learning Outcomes and then competencies. The delineation of attributes started with the attributes in the red zone of the Attributes Spectrum (attributes predominately acquired in a clinical setting), and worked up the spectrum towards the yellow zone (attributes which can be acquired in settings other than clinical settings).

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Sample Attributes Spectrum

Predominately acquired

in settings other than

clinical settings.

Requires some

degree of clinical setting.

Predominately acquired

in clinical settings.

Student Learning Outcomes Now that there was an identifiable starting point for the delineation process, there was still the challenge of undertaking the delineation of attributes into competencies. To help address the paradigm shift from goals, objectives or statements to one of an outcome - based approach; the use of Student Learning Outcomes was incorporated as an intermediary step. Thus the delineation of attributes would focus on those attributes which rely on clinical placements, and delineate them into Student Learning Outcomes and then competencies.

Delineation process concept map

To assist with the delineation process, medical schools were contacted and requested to supply curriculum documents for clinical placements which occur in the second half of a medical program. The documents helped form the basis of the Student Learning Outcomes and competencies. The use of these documents also assisted in developing competencies which were appropriate for the medical graduate and would also ensure further learning. The Student Learning Outcomes (SLO’s) and competencies developed were purposely kept broad and high level so as to avoid a reductionist approach. The intention behind writing the SLO’s and competencies was to capture the essence of the attribute, and express this in an outcome - based/competency model. The goal was to produce a framework which had a functional use – a framework which contained a large number of competencies would be of little benefit.

AMC graduate attributes ordered along the spectrum, according to their degree of reliance on being developed in a clinical setting.

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Critiquing against Australian Curriculum Framework for Junior Doctors (ACFJD) The competencies developed for each attribute were dynamically critiqued against the ACFJD. This critiquing against the ACFJD helped to develop competencies which were not beyond the level of the medical graduate. By analysing the competencies against the ACFJD, vertical integration was also addressed. Using the ACFJD as a benchmark has established the basis for a future mapping exercise of the competencies developed for the medical graduate to the ACFJD capabilities. Lists of common diagnostic and procedural skills The delineation process for attributes pertaining to diagnostic and procedural skills (attributes 18 and 15) lead to the development of lists of common diagnostic skills and procedural skills. The use of lists in the Framework aims to identify what diagnostic and procedural skills a medical graduate should have attained regardless of the medical program they undertook. These lists were developed via a modified Delphi technique from data obtained from three medical schools. Refinement of these lists will help in the identification of competencies which are developed in a clinical setting. These lists will be useful to health service providers as it will help to identify the competencies medical graduates have acquired in clinical settings. Common clinical rotations The draft Framework utilised the Attributes Spectrum as the foundation of the framework. The introduction of the eight common clinical rotations as identified by the National Clinical Training Review Report was incorporated into the Framework. The eight clinical rotations provided the context for the development of the Student Learning Outcomes and competencies in a clinical setting. The eight common clinical rotations as identified by the National Clinical Training Review Report are: Emergency Medicine/Critical Care, General Practice and Community, General Medicine/Medicine, Obstetrics and Gynaecology, Psychiatry and Mental Health, Paediatrics, Surgery and Others.

Draft framework including eight common clinical rotations concept map

The mapping of competencies to the eight common clinical placements has helped set the context for the competencies which have been developed. Currently, all of the competencies developed are mapping to all of the eight clinical rotations. This is to be expected as the delineation process focused on those attributes which are developed in a clinical setting.

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Mind mapping software A noteworthy outcome regarding the development of the Framework was the incorporation of mind mapping software to present the Framework. The use of an electronic format for the Framework provided a more interactive and dynamic way to present the framework. The mind mapping allows for greater flexibility as information can be added or subtracted, according to the needs of the user. The electronic format also permits the user to map backwards from the competencies to the AMC attributes. Whilst the mind mapping concept is good, it is still in its developmental stage. It is hoped that future work will involve the refining of the electronic format to enable a more sophisticated version. Writing Group The Writing Group advanced the project work significantly and its meetings were a major component of the methodology of the project enabling the project’s objectives to be achieved. The face to face nature of the meetings allowed for consultation with key figures in medical education to ensure stakeholder engagement. The meetings also assisted in the utilisation of medical educator’s expertise in identifying competencies appropriate for the medical graduate. Stakeholder Consultation There was extensive consultation with stakeholders throughout the entire project term. Competence – based medical education is currently a topic of significant interest in not only medical schools but also heath departments, prevocational medical education councils and specialty colleges. Stakeholders from related projects, medical schools, health departments and prevocational medical education colleges showed interest in the Competencies Project due to the unique focus of the project on clinical placements. This level of stakeholder consultation is demonstrated by the large number of people/organisations consulted with over the project period. A list of people/organisations consulted is attached as Appendix B. In depth discussions were held with a number of key stakeholders to assist with the documentation of competencies. Medical schools, Clinical Rotation Leaders, Heads of Clinical Departments in medical schools, post graduate medical education councils and Health Workforce Australia were consulted to discuss the level necessary for a medical graduate to commence work as an intern. These discussions assisted with the documentation of Student Learning Outcomes and competencies and also assisted with the contextualisation of the project work. The project was reported on at key meetings where Medical Deans were represented. Of particular importance were the presentations at the Medical Deans’ Annual Conference and to the Australian Medical Council’s Medical Schools Accreditation Committee (MedSAC). The presentation to the Deans at the Medical Deans’ Annual Conference gave the Deans the opportunity to comment on the direction and progress of the project. The project received solid endorsement from the Deans and recognition that this was a useful project for medical education. This was very pleasing as it reinforced the direction of the project and generated significant interest from medical schools in the upcoming Consensus Conference. Following on from the Medical Deans’ Annual Conference, the Chair and the Project Manager presented the project to the MedSAC board meeting in October 2010. This was an opportunity to brief the AMC on the work conducted thus far. It was also an opportunity to advise the AMC that there had been a number of attributes identified by the Writing Group deemed suitable for revision. It is hoped that there will be future collaborations with the AMC regarding the review of their attributes.

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The convening of the Consensus Conference was an opportunity to bring together stakeholders for a face to face meeting to discuss and refine the work conducted on the Framework. The participation was opened up to a wider stakeholder audience, namely individuals and organisations that had been consulted during the project period. The wider participation facilitated greater stakeholder buy in and an excellent opportunity to elicit targeted feedback. The participation consisted of individuals from the Reference Group, Writing Group, Medical Schools, AMSA, Health Departments, CPMEC and related projects. A full participation list is included as Appendix C. The Consensus Conference was a resounding success. It provided a large stakeholder audience with a significant insight into the work being undertaken on the development of competencies which rely on clinical placements. There was substantial targeted feedback elicited, and solid endorsement of the Framework was achieved. The major outcomes from the Consensus Conference were: 1. A wider stakeholder audience being made aware of the Competencies Project and having a

greater understanding of the work conducted during the project period. 2. Solid endorsement of the draft framework. There was general acknowledgement that the

Competencies Project was a valuable project for outlining the competencies which a graduate will acquire in a clinical placement. The framework may be used to assist schools in achieving the AMC graduate attributes in clinical settings.

3. Strong endorsement of the need to review the AMC medical graduate attributes. 4. Support for a proactive approach to coordinating the various projects in the health and education

sectors which are addressing clinical competence, academic standards, quality and safety, especially HWA’s simulated learning environments project.

5. Strong support for further development of the list of graduate skills and competencies related to investigations, clinical examinations and procedures. Further work to complete these lists was seen as high priority.

6. Feedback on the delineated attributes and lists of common diagnostic and procedural skills be incorporated into the Framework and reviewed by the Writing Group and the Reference Group.

7. Recommendations for a second stage phase of the project to include mapping the competencies developed with the ACFJD capabilities specifying the level of achievement of competencies at each level.

Notes from the Consensus Conference are attached as Appendix D. The Consensus Conference yielded a significant amount of feedback on the Student Learning Outcomes and then competencies. There was also a large amount of feedback provided regarding the lists of common diagnostic and procedural skills for the medical graduate. Following the Consensus Conference, the project focused on the feedback provided on the Student Learning Outcomes and then competencies in order to refine the Framework. The feedback was collated and reviewed by the Writing Group at the last meeting in January 2011. The Writing Group reviewed all of the thirty delineated attributes and refined the Framework accordingly.

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Refining the Framework The final Writing Group Meeting produced some significant changes to the Attributes Spectrum and the Framework. In order to address the challenge of interrelated attributes and competencies there were four significant changes. 1. Better alignment of attributes which have concurrent themes around knowledge and

understanding and the skills associated with these attributes. 2. Attributes 4 and 5 specifying knowledge and understanding for management and diagnostic

procedures, were moved down the Attributes Spectrum so that they are next to attributes 19 and 17 specifying the associated skills and abilities for management and diagnostic procedures.

3. For attributes which have concurrent themes, the competencies can refer to those attributes. 4. The inclusion of the AMC graduate attribute ‘stem’ in the Attributes Spectrum. The stems are:-

Knowledge and Understanding Attributes 1 -12 ‘Graduates completing basic medical education should have knowledge and understanding of’: Skills Attributes 13 -25 ‘Graduates completing basic medical education should have developed the following skills and abilities’: Attitudes as they affect Professional Behaviour Attributes 26 – 40 ‘At the end of basic medical education, students should demonstrate the following professional attitudes that are fundamental to medical practice’: The stems are included as a footnote at the bottom of the Attributes Spectrum.

The Reference Group endorsed the changes to the Attributes Spectrum and the Framework at its final meeting in January, 2011. The final version of the Attributes Spectrum is attached as Appendix E. The completed Framework of Medical Graduate Outcomes is attached as Appendix F. As mentioned previously, there is also a mind mapped version of the Framework which accompanies this report. Endorsement of the Framework There has been a solid endorsement of the Framework and this is represented by the extensive consultation which occurred during the project period. The endorsement of the Framework is also demonstrated by the attendance of such a diverse stakeholder group at the Consensus Conference. The Consensus Conference Participation and Notes are further evidence to the level of support the Competencies Project has received. The Deans endorsed the Competencies Framework at the Medical Deans’ 2010 Annual Conference and have continued to provide support at the meetings of the Medical Deans Executive. A letter of support from Medical Deans is attached as Appendix G.

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Future Use of the Framework The Competencies Project provides some clarity and transparency around the learning that occurs in a clinical training environment. It is Medical Deans’ intention that once the lists of common diagnostic and procedural skills for the medical graduate have been further developed the Framework will be made available to medical schools for their use. It is anticipated that the Framework will be particularly helpful for medical schools that are establishing new clinical placements, such as those growth places currently being established under Health Workforce Australia’s Clinical Training Funding. The Framework has also been identified as being useful for clinical supervisors who are teaching medical students in clinical placements. There may be opportunity to liaise further with Heads of Disciplines and Heads of Clinical Schools to establish if the Framework would be beneficial for clinical teachers. Once the Framework is ready for release to medical schools, it is hoped that there will be an opportunity to discuss the Framework further with medical schools and establish how it can be used to help develop and refine clinical placements. Next steps The next logical body of work for the Competencies Project is further refinement of lists of common diagnostic and procedural skills for the medical graduate. There was overwhelming support for this obtained at the Consensus Conference. As this work falls out of the scope of the current project, incorporating the feedback obtained on these lists and refining the lists of common diagnostic and procedural skills will form the basis of a second stage of work. It is anticipated that this will involve further consultation with medical schools and Directors of Clinical Training to ascertain the content of the lists of common diagnostic and procedural skills. The refinement of these lists will also aim to identify to what level of achievement the medical graduate has obtained these skills. A draft version of lists of common diagnostic and procedural skills is included as Appendix F. Mapping of the medical graduate competencies to the ACFJD was also seen as a beneficial exercise to address vertical integration. Once the common diagnostic and procedural skills have been established and the level of achievement specified, future work will involve a mapping exercise to the ACFJD skills and procedures section. The aim of this exercise will be to articulate what level of skill is obtained for the medical graduate and what level of achievement there is for the same skill after PGY2. Future work will also involve the refining of the delineation process for Attribute 21 – which references the National Patient Safety Education Framework. This is a 214 page document with a four point matrix system which identifies the levels of a health worker from cleaners to the CEO of a hospital. This attribute needs to be reviewed separately so that there is a not large amount of competencies developed relating to the National Patient Safety Education Framework. This would potentially slant the Competencies Framework in a different direction. Future recommendations also involve the coordination of the various projects in health and education sectors to ensure that the projects align, and true vertical integration of the curriculum can occur, thus improving clinical education. The sharing of information in the future with HWA’s Simulated Learning Environments project for Medicine will help to align the Competencies Project and HWA’s project findings. The alignment of future work for the Competencies Project with existing projects in medical education will ensure an

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integrated approach to projects which aim to improve the quality of clinical placements in medical schools. There was also strong support for the revision of the AMC graduate attributes from the Reference Group and participants of the Consensus Conference. Medical Deans will liaise with the AMC at a future date when the AMC undertakes this process. At the time of writing this Final Report, Health Workforce Australia have provided in principle support for a second stage of work to proceed on the further development of the lists of common diagnostic and procedural skills for the medical graduate. The development of these lists of diagnostic and procedural skills was seen as a high priority from key stakeholders. The Competencies Project hopes to retain the expertise of the Reference Group and Writing Group should this funding become available. Conclusion The Developing a Framework of Competencies for Medical Graduate Outcomes Project has achieved significant results in the last twelve months. The framework of competencies which rely on clinical placements has provided some precision and transparency around the learning which occurs in a clinical placement. The project has brought together key figures in medical education to discuss the quality and content of clinical training. It is hoped that the future intended work of the Competencies Project will encourage innovation and diversity in teaching and learning to help assist with capacity building to create quality clinical placements for the future. This project would not have been possible without the support from the Strategic Medical Education Section, Australian Government Department of Health and Ageing. Medical Deans is grateful for their support and looks forward to working with the Department on future related work.

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Summary of Key Outcomes against Project Objectives A summary of the major outcomes of each project objective follows: 1. Identify the competencies associated with each of the attributes in knowledge, skills and

attitudes/behaviours specified by the AMC for competent medical graduates and which depend on clinical placements.

Key achievements:

• The development of the Attributes Spectrum which identified which attributes relied on clinical placements.

• The delineation of thirty of the AMC’s graduate attributes which rely on clinical placements, as identified on the Attributes Spectrum, into Student Learning Outcomes and then competencies.

• The incorporation of the Attributes Spectrum, Student Learning Outcomes and competencies into a mind mapping framework to develop a Framework of Competencies for Medical Graduate Outcomes.

2. Use the AMC Accreditation Standards and Processes for medical graduates (including

International Medical Graduates), the Medical Deans’ National Clinical Training Review report, The Australian Curriculum Framework for Junior Doctors (ACFJD) and any other relevant reports/projects as the basis of the development of a document that maps competencies to AMC prescribed attributes and which enables graduates to practice at the beginning of the PGY1 Year.

Key achievements:

• The AMC graduate attributes are the anchor point for the project to identify attributes which rely on clinical placements, and to delineate competencies from these attributes.

• The Medical Deans’ National Clinical Training Review report was utilised to identify the eight common clinical rotations which forms the basis of clinical placements for the project.

• The competencies developed were dynamically critiqued against the ACFJD. • Relevant reports and projects helped in the development of the framework, these have been

covered extensively in Progress Report 1, 2, Draft Final Report and in Section One of this report.

3. Ensure engagement of stakeholders in the identification and specification of competencies.

Key achievements: • Extensive consultation with the Reference Group and Writing Group which includes

representatives from key organisations in medical education. • Liaising with related projects with concurrent themes around competency and academic

standards. • Involvement of the medical schools in the determination of competencies and the level required

for a graduating medical student. • Convening of the Consensus Conference which was a major forum of key stakeholders to discuss

the proposed framework and to elicit targeted feedback.

4. Ensure that the competencies documented are appropriate for a graduating medical student to commence work as an intern in the standard clinical rotations of the intern year (PGY1).

Key achievements:

• Utilisation of medical educators with expertise in teaching medical graduates.

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• Competencies developed were dynamically critiqued against ACFJD to ensure they were appropriate for a graduate to commence work as an intern.

• Consultation with medical schools to ensure competencies developed were appropriate for the medical graduate.

• Convening of the Consensus Conference to elicit feedback as to the level necessary for a medical graduate.

5. Ensure that the competencies enable a graduating medical student to continue to undertake

further learning and clinical training.

Key achievements: • The introduction of lists of common diagnostic and procedural skills which can be added to

through the prevocational and vocational years. • Cross referencing competencies developed to ACFJD to address vertical integration. By achieving the principle objectives of the project, the Medical Deans’ Competencies Project has achieved the aim of the project which was to identify and document competencies for the medical graduate outcomes required by the AMC and which depends on clinical placements.

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List of Appendices

A. Reference Group and Writing Group Membership

B. Stakeholder Consultation List

C. Consensus Conference Participation

D. Consensus Conference Notes

E. Final Attributes Spectrum

F. Framework of Competencies

G. Deans’ Letter of Support

Reference Group and Writing Group Membership Appendix A

Medical Deans’ Competencies Project Final Report February 2011

Reference Group Member

Representing

Professor Allan Carmichael (Chair) Medical Deans Professor Nicholas Glasgow (Deputy Chair) Medical Deans and Australian Medical Council Dr Andrew Singer Department of Health and Ageing Ms Meredith Williams Department of Health and Ageing Dr Jagdishwar Singh Confederation of Post Graduate Medical Education

Councils Dr Gregory Keogh Confederation of Post Graduate Medical Education

Councils/Clinical Education and Training Professor David Prideaux Medical Educators Professor Fiona Lake Medical Educators/Clinical Teachers Dr Michael O’Sullivan Australian Medical Association Council Doctors in

Training Mr Sam Whitehouse Australian Medical Students’ Association Dr Morton Rawlin Committee of Presidents of Medical Colleges Dr Geoff Copland Clinical Supervisors Associate Professor Andrew Clinical Supervisors Ms Teresa Valentine Health Workforce Australia Ms Monique Hourn Medical Deans

Member Representing Professor Allan Carmichael Medical Deans Professor Nicholas Glasgow Medical Deans and Australian Medical Council Professor David Prideaux Medical Educators Dr Jagdishwar Singh Confederation of Postgraduate Medical Education

Councils Professor Fiona Lake Medical Educators/Clinical Teachers Dr Michael O’Sullivan Australian Medical Association Council Doctors in

Training Mr Sam Whitehouse Ms Monique Hourn

Australian Medical Students’ Association Medical Deans

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s P

rofe

ssor

Bre

ndan

Cro

tty

Pro

fess

or A

lison

Jon

es

Pro

fess

or J

ustin

Bei

lby

Mul

tiple

tim

es

Mul

tiple

tim

es

Med

ical

Sch

ools

D

r Je

nnife

r S

chaf

er (

UQ

) D

r K

aren

D’S

ouza

(D

eaki

n)

A/P

rof R

osa

Can

ales

e (N

otre

Dam

e S

ydne

y)

Ms

Jenn

ifer

Lind

ley

(Mon

ash)

P

rofe

ssor

Phi

llip

Jone

s (U

NS

W)

Pro

fess

or D

avid

Prid

eaux

(F

linde

rs)

Dr

Fio

na H

awth

orne

(U

Q)

Pro

fess

or F

iona

Lak

e (U

WA

) P

rofe

ssor

Chr

is D

enni

s (S

ydne

y)

Dr

Julie

Ash

(F

linde

rs)

A/P

rof M

ellic

k C

heha

de (

Ade

laid

e)

A/P

rof W

endy

Hu

(UW

S)

A/P

rof A

ndre

w H

ill (

Auc

klan

d)

Ms

Joy

Rud

land

(O

tago

) P

rofe

ssor

Dav

id H

arris

(S

ydne

y)

Pro

fess

or Ia

n S

ymon

ds (

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cast

le)

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rof S

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r (M

onas

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Pro

fess

or B

en C

ann

y (M

onas

h)

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rof C

ampb

ell (

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ash)

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/Pro

f Gar

y R

oger

(G

riffit

h)

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fess

or G

eoff

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oll (

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bour

ne)

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rof C

arol

e S

teke

tee

(Not

re D

ame

Fre

man

tle)

Pro

fess

or M

icha

el F

rom

mer

(S

ydne

y)

Pro

fess

or R

icha

rd M

urra

y (J

CU

) P

rofe

ssor

Dav

id K

andi

ah (

UW

A)

Pro

fess

or B

rian

Jolly

(M

onas

h)

Pro

fess

or J

ames

Vic

kers

(U

TA

S)

Pro

fess

or C

raig

Zim

itat (

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AS

)

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tiple

tim

es

Mul

tiple

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Mul

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tiple

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e M

ultip

le ti

mes

M

ultip

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M

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M

ultip

le ti

mes

Dep

artm

ent o

f Hea

lth a

nd A

gein

g M

r T

ony

Hyl

and

Ms

Mer

edith

Will

iam

s P

rofe

ssor

Jud

y S

earle

M

s Li

na C

achi

a D

r A

ndre

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tiple

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tiple

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tiple

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tiple

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keho

lder

Org

anis

atio

n

Indi

vidu

al

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ting

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onfe

dera

tion

for

Pos

t Gra

duat

e M

edic

al E

duca

tion

Cou

ncils

(C

PM

EC

) D

r Ja

gdis

hwar

Sin

gh

Dr

Gre

g K

eogh

M

s D

ebor

ah P

altr

idge

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tiple

tim

es

Mul

tiple

tim

es

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tral

ian

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ical

Cou

ncil

Pro

fess

or N

icho

las

Gla

sgow

P

rofe

ssor

Hea

ther

Ale

xand

er

Ms

The

anne

Wal

ters

M

ed S

AC

Boa

rd

Mul

tiple

tim

es

Oct

ober

201

0 B

oard

Mee

ting

Aus

tral

ian

Med

ical

Ass

ocia

tion

– C

ounc

il of

Doc

tors

in

Tra

inin

g D

r M

icha

el B

onni

ng

Dr

Mic

hael

O’S

ulliv

an

Mul

tiple

tim

es

Aus

tral

ian

Med

ical

Stu

dent

s’ A

ssoc

iatio

n (A

MS

A)

Mr

Ros

s R

ober

ts –

Tho

mso

n M

r S

am W

hite

hous

e M

ultip

le ti

mes

H

ealth

Wor

kfor

ce A

ustr

alia

(H

WA

) M

s Lu

isa

Abi

uso

Ms

Ter

esa

Val

entin

e P

rofe

ssor

Liz

Far

mer

Mul

tiple

tim

e M

ultip

le ti

mes

A

ustr

alia

n Le

arni

ng a

nd T

each

ing

Cou

ncil

(ALT

C)

Pro

fess

or C

hris

tine

Ew

an

Pro

fess

or A

man

da H

ende

rson

A

/Pro

f Mar

ee O

’Kee

fe

Hea

lth W

orkf

orce

Aus

tral

ia –

rel

ated

pro

ject

s S

imul

ated

Lea

rnin

g E

nviro

nmen

ts P

roje

ct

Nat

iona

l Hea

lth C

ompe

tenc

y F

ram

ewor

k

Pro

fess

or B

rian

Jolly

M

s K

atie

Wal

ker

Ms

Bev

erle

y S

utto

n A

/Pro

f Sha

ron

Bro

wni

e P

rofe

ssor

Hel

en C

hene

ry

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tiple

tim

es

Mul

tiple

tim

es

Mul

tiple

tim

es

Com

mitt

ee o

f Pre

side

nts

Med

ical

Col

lege

s (C

PM

C)

M

r Le

s A

polo

ny

Dr

Mor

ton

Raw

lin

Mul

tiple

tim

es

Roy

al A

ustr

alia

n C

olle

ge o

f Psy

chia

tris

ts

Dr

And

rew

Gos

bell

N

SW

Hea

lth D

epar

tmen

t D

r Li

nda

Mac

pher

son

Ms

Rob

yn B

urle

y

NS

W C

ET

I D

r G

reg

Keo

gh

Q

ueen

slan

d H

ealth

C

linE

dQ

A/P

rof V

icto

ria B

razi

l

Clin

ical

Sup

ervi

sors

D

r G

eoffr

ey C

opla

nd

A/P

rof A

ndre

w H

ill

Dea

ns

Med

ical

sch

ools

C

PM

EC

C

PM

C

DoH

A

HW

A

AM

AC

DIT

A

MS

A

Clin

ical

sup

ervi

sors

M

edic

al E

duca

tors

Ref

eren

ce G

roup

Mem

bers

hip

Writ

ing

Gro

up M

embe

rshi

p R

efer

ence

Gro

up M

eetin

gs 1

– 6

W

ritin

g G

roup

Mee

tings

1 -

3

Consensus Conference Participation Appendix C

Reference Group Organisation

Professor Allan Carmichael (Chair) Medical Deans

Professor David Prideaux Medical Educator/Flinders University

Dr Andrew Singer (Medical Advisor) DoHA

Associate Professor Andrew Hill Clinical Supervisors

Mr Sam Whitehouse AMSA

Dr Jagdishwar Singh CPMEC

Ms Teresa Valentine HWA

Dr Gregory Keogh CPMEC/Director of CETI

Dr Morton Rawlin CPMC

Dr Geoffrey Copland Clinical Supervisors

Ms Monique Hourn Medical Deans

DEANS or Nominees UNIVERSITY

Professor Warwick Bagg Auckland

A/Professor Gary Rogers Griffith

Professor Richard Murray James Cook

Professor Ben Canny Monash

Professor Geoff McColl Melbourne

A/Professor Carol Steketee Notre Dame Fremantle

Professor Michael Frommer Sydney

Professor David Kandiah UWA

A/Professor Craig Zimitat UTAS

External Stakeholders Representing

A/Professor Maree O'Keefe ALTC

Professor Amanda Henderson ALTC

Ms Deborah Paltridge CPMEC

A/Professor Victoria Brazil ClinEdQ

Dr Jennifer Schafer UQ

Professor Brian Jolly Monash University/HWA SLE Audit Project

Ms Beverley Sutton Monash University/HWA SLE Audit Project

Dr Linda MacPherson NSW DOH

Professor Liz Farmer Health Workforce Australia

Mr Philip Pogson Facilitator

Ms Giti Datt Medical Deans (scribe)

Consensus Conference Participation Appendix C

Referenc e Group Apologies

Professor Nicholas Glasgow (Deputy Chair) Medical Deans/ANU/AMC

Professor Fiona Lake Medical Educators/UWA

Dr Michael O’Sullivan AMACDIT

Professor Allison Jones UWS

Ms Meredith Williams DoHA

Appendix D

Competencies Project Consensus Conference

Notes Thursday, 11 November 2010 Melbourne Airport Hilton Victoria South Ballroom 10am – 4pm Attendees : Professor Allan Carmichael (Chair), Professor David Prideaux, Dr Andrew Singer, A/Prof Andrew Hill, Mr Sam Whitehouse, Dr Jagdishwar Singh, Ms Teresa Valentine, Dr Greg Keogh, Dr Morton Rawlin, Dr Geoffrey Copland, Ms Monique Hourn, Professor Warwick Bagg, A/Prof Gary Rogers, Professor Richard Murray, Professor Ben Canny, Professor Geoff Mccoll, A/Prof Carole Steketee, Professor Michael Frommer, Professor David Kandiah, A/Prof Craig Zimitat, A/Prof Maree O’Keefe, Professor Amanda Henderson, Ms Deborah Paltridge, A/Prof Victoria Brazil, Dr Jennifer Schafer, Professor Brian Jolly, Ms Beverley Sutton, Dr Linda MacPherson, Professor Liz Farmer, Mr Philip Pogson, Ms Giti Datt. Apologies: Professor Nicholas Glasgow, Professor Fiona Lake, Dr Michael O’Sullivan, Ms Meredith Williams, Professor Alison Jones. Session 1: Setting the scene Participants were provided with a background to the project, an overview and comments from key stakeholders. Key discussion points included: • Student Learning Outcomes as part of the framework help to delineate attributes which have

multiple components. SLO’s allows for the illustration of tacit knowledge which cannot always be codified into competencies.

• The framework presented is not a prescriptive approach but a descriptive one which will allow medical schools to do things in a different way.

• Acknowledgments that the AMC graduate attributes require revision; they do not capture observable behaviour. This project will be able to provide feedback to the AMC about which attributes need revising.

• The need to acknowledge simulation in a clinical setting and to link in the Competencies Project project with HWA’s SLE project.

DoHA perspective • The competencies project will provide better delineation around what occurs in a clinical

placement. • Vertical integration is the ultimate goal. There is a level of consistency that DoHA would like to

see whilst taking into consideration that medical schools would like to retain control over their own approaches.

• A hopeful outcome would be that medical schools will be able to do things as they see best for their program but ultimately we will all be heading towards a common outcome.

HWA perspective • HWA are interested in delineating what occurs in a clinical placement but also looking at future

meanings of the health workforce and competencies. • HWA are conducting a suite of competency projects looking at the national and international

competency landscape.

• There are parallels between this project and clinical supervision and the competence of supervisors.

• HWA is very supportive of any efforts to make competencies more explicit any profession.

CPMEC perspective • This project runs in parallel with the prevocational training project, ACFJD. • This project is useful for supervisors because they will now understand what they have to do on

the ground as clinical supervisors. • The delineation of the attributes can help form the basis of situational learning and assessment. • The competencies presented today are sound building blocks for future work, collaboration is

important and projects need to keep on mapping to make sure things align. • Simulation will be an important component of future work. Medical Educators perspective • Competency-Based frameworks are a way of organising curriculum and it focuses on outcomes

which is good because things can be transparent and students can be clear on what they need to achieve. It is easy to relate to practice.

• Negatives to Competency-Based frameworks – they are difficult to write. There is a very real risk of them being reductionist. There are some things that you cannot measure, like observable behaviour.

• A medical graduate has to have lots of contact with lots of patients to move from novice to expert. • This project is important in increasing transparency and clarity particularly as we are expanding

our clinical placements. UQ perspective • UQ developed a competency based assessment for their year one MBBS program due to the

increase in student numbers and wanting to maintain standards. • Broke year one down into sections and ended up with a list of competencies. This project was

piloted one year and then implemented the next year. • Outcomes of the project were that everyone knew what they had to do, teachers, students and

examiners. • All students are assessed and if students do not reach the standard they are given extra teaching

until they do. No student falls through the cracks. • Now looking at other areas of the course where this can be implemented and linked into other

areas of the curriculum.

Session 2: Review of work developed Participants were provided with a brief overview of the methodology of the delineation process, introduction of appendices A & B and demonstration of the mind mapping framework. Key discussion points included: • Need to revise previous competencies developed to ensure consistency in the framework. • Mind mapping tool would be a useful tool to generate a report which identifies gaps. • Where competencies are interrelated and are expressed in other attributes, the approach has had

to be an ad hoc one. If this project is to deal with this systematically another matrix would be needed.

Breakout session 1: Participants formed break out groups and provided feedback on a set of attributes from varied positions along the attributes spectrum. Key discussion points included: • The need to change some of the verbs at the beginning of the competencies. • The introduction of a glossary of verbs so there is a consensus for what verbs are in the

competency and how they were used. • In general, participants were happy with the principles of the SLO’s and the competencies. • Some of the SLO’s and competencies developed from attributes in the yellow zone of the

attributes spectrum are beyond the level of a graduate and need revision. • The stem of SLO’s ‘the student has the ability to’ has created some difficulty. • Recognise that content may be modified by context. • Need a broader clinical input into the framework to make sure that things are lined up

appropriately. • Need to develop a ‘laundry list’ of common conditions and common information technology

resources to show what is relevant. Summation of breakout session one: • Participants endorsed the principles behind the SLO’s and competencies developed. • There is the need for further revision of the work presented. • Possible development of a glossary of verbs, laundry lists of common conditions and information

technology resources. • Acknowledgement that there will be difficulties in trying to capture metacognitive and tacit

knowledge in words/competencies. • General consensus that the AMC graduate attributes need to be revised. • General support for a proactive approach to coordinating the various projects in the health and

education sectors which are addressing clinical competence, academic standards, quality and safety.

Breakout session 2: Review of appendices A & B Participants resumed their break out groups and reviewed appendices A & B. Key discussion points included: • Need to identify at what level graduates need to be familiar with diagnostic skills and procedural

skills. • Need to be more specific about procedural skills; i.e.’ need to know about versus perform’. • Need to decipher with diagnostic skills whether the graduate can interpret the report or point out

abnormal findings to the patient. • Need to define ‘What is a procedure and what is an examination’? • Possible introduction of a matrix for diagnostic skills and procedural skills. i.e. understand,

observe, under supervision, performs independently. • Need to add procedural skills as they relate to men’s health. • Need to get program directors together to discuss the detail in appendix A & B. • Important to map to ACFJD. • Need to differentiate between interpretation of reports and interpretation of films. • Cross check lists to ensure that there is not a doubling up of procedures and diagnostics.

Summation of breakout session two: • Need to recognise the framework from a practitioner centric point of view which includes patients

and risks to patients. Risk needs to be managed versus what students need to achieve. Important that health services are involved with this work.

• Possible incorporation of a statement that students should not do these things until we are absolutely certain that they can do them in a simulated environment.

• Important and helpful to look at these lists. We don’t have a common list of diagnostic or procedural skills across our medical schools. Further refine of these lists will help to establish what graduates should be able to do.

• The formation of these lists will help supervisors know what they have to teach to medical students.

Session 3 Related Projects ACFJD • ACFJD has been picked up and modified by New Zealand. • Project has not been funded since June. • Looking to implement assessment but need to learn from the UK junior doctor problems.

HWA: SLE Project • SLE project has revealed that medical schools are very interested in SLE. • AMC does not have a view at the moment as to whether they recommend simulation as a method

of teaching. • There are some topics which are being taught almost entirely in simulation e.g. basic life support. • The project has revealed that one size does not fit all when it comes to simulation.

ALTC Academic Standards Project • Academic Standards Project looks at the attributes of a graduate on the day they graduate as

opposed to certification for competency to practice. • The focus of the project is to look at the outcomes of graduates at the professional entry level

standard. What does every graduate need to have? • The project was able to obtain competency standards or accreditation standards for all

disciplines. Thematic analysis was conducted and competency standards were mapped to all six threshold learning outcomes.

• Information is being disseminated to relevant discipline bodies and hopefully there will be something available publicly through the ALTC very soon.

AMC Competence-Based Medical Education Paper • The paper released in August is the penultimate draft. • There will be a conference in December to look at the how tacit and codified knowledge sits within

a competency based framework.

Recommendations • General agreement that the framework presented is a useful one, and that it is useful for medical

schools and perhaps medical education in general particularly in the area of assisting medical schools to have more specification around the competencies a graduate could be expected to acquire in a clinical placement. The framework could be used as a tool to assist schools as they look at new clinical placements and clinical settings.

• General support for the AMC to review their graduate attributes.

• Support for the means of coordinating other projects in the sector which focus on clinical competence.

• Agreement that we ought to develop a common list of very basic skills/competencies around examinations and procedures. General agreement that there is a place for simulation in the acquisition of these skills and competencies.

• May be useful to develop a simulation spectrum for which skills can be acquired in a simulation setting.

• Feedback provided regarding the rewording of SLO’s and competencies will be incorporated by the Writing Group and the Reference Group.

• There is some discontinuity between the attributes. The ordering of attributes according to skills, knowledge and attitudes or importance of clinical placements results in a loss of cohesion of the actual outcome which we are looking for. The project may have to look at some matrix which brings those together.

• Recommendation that schools use the work from this project to investigate the quality of their clinical placements so that schools don’t make the assumptions that the standards are there when it could be an inadequate environment. There may need to be further consultation with heads of clinical schools for this to occur.

Summation and Action Plan • Integrate and implement the recommendations mentioned above and weave into the draft final

report. • Incorporate vertical integration into this project by talking with other organisations such as

CPMEC and CPMC, other groups represented such as MTRP and higher education groups such as ALTC. Meeting concluded at 3.30pm

ATTRIBUTES SPECTRUM Appendix E

For Attributes 1- 12 “Graduates completing basic medical education should have knowledge and understanding of” For Attributes 13 – 25 “Graduates completing basic medical education should have developed the following skills and abilities” For Attributes 26 – 40 “At the end of basic medical education students should demonstrate the following professional attitudes that are fundamental to medical practice”

© Medical Deans Australia and New Zealand, Competencies Project

(1) Scientific method relevant to biological, behavioural and social sciences at a level adequate to provide a rational basis for present medical practice, and to acquire and incorporate the advances in knowledge that will occur over their working life. (2) The normal structure, function and development of the human body and mind at all stages of life, the factors that may disturb these, and the interactions between body and mind. (27). Recognition that the doctor should have the necessary professional support, including a primary care physician, to ensure his or her own well-being. (36). An appreciation of the systems approach to health care safety, and the need to adopt and practise health care that maximises patient safety including cultural safety. (30) A commitment to ease pain and suffering. (7) The principles of health education, disease prevention and screening. (38). A desire to achieve the optimal patient care for the least cost, with an awareness of the need for cost-effectiveness to allow maximum benefit from the available resources. (31). A realisation that it is not always in the interests of patients or their families to do everything that is technically possible to make a precise diagnosis or to attempt to modify the course of an illness. (10) Systems of provision of health care in a culturally diverse society including their advantages and limitations, the principles of efficient and equitable allocation and use of finite resources, and recognition of local and national needs in health care and service delivery. (3) The aetiology, pathology, symptoms and signs, natural history, and prognosis of common mental and physical ailments in children, adolescents, adults and the aged. (35) An appreciation of the responsibility to contribute towards the generation of knowledge and the professional education of junior colleagues. (34) An appreciation of the responsibility to maintain standards of medical practice at the highest possible level throughout a professional career. (24) The ability to interpret medical evidence in a critical and scientific manner and an understanding of the epidemiology of disease in differing populations and geographic locations. (29) Respect for community values, including an appreciation of the diversity of human background and cultural values. (26) Recognition that the doctor’s primary professional responsibilities are the health interests of the patient and the community. (33) A realisation that doctors encounter clinical problems that exceed their knowledge and skills, and that, in these situations, they need to consult and/or refer the patient for help, in clinical, cultural social and language related matters as appropriate. (12) The principles of ethics related to health care and the legal responsibilities of the medical profession. (28) Respect for every human being, including respect of sexual boundaries. (25) The ability to use information technology appropriately as an essential resource for modern medical practice. (9) Factors affecting human relationships, the psychological, cultural and spiritual well-being of patients and their families, and the interactions between humans and their social and physical environment. (40) A realisation that one's personal, spiritual, cultural or religious beliefs should not prevent the provision of adequate and appropriate information to the patient and/or the patient's family, or the provision of appropriate management including referral to another practitioner. (8).The principles of amelioration of suffering and disability, rehabilitation and the care of the dying. (6). Normal pregnancy and childbirth, the more common obstetrical emergencies, the principles of antenatal and postnatal care, and medical aspects of family planning. (20) Communication skills, including being able to listen and respond, as well as being able to convey information clearly, considerately and sensitively to patients and their families, doctors, nurses other health professionals and the general public. (21) The skills needed to work safely as an intern, as outlined in the National Patient Safety Education Framework developed by the Australian Council for Quality and Safety in Health Care. (22) The ability to counsel patients sensitively and effectively and to provide information in a manner that ensures patients and families can be fully informed when consenting to any procedure. (37). A commitment to communicating with patients and their families, and to involving them fully in planning management. (39). A preparedness to work effectively in a team with other health care professionals. (11). Indigenous health, including the history, cultural development and health of the Indigenous peoples of Australia or New Zealand. (13) The ability to construct, in consultation with a patient, an accurate, organised and problem-focused medical history. (14) The ability to perform an accurate physical and mental state examination. (32) An appreciation of the complexity of ethical issues related to human life and death, including the allocation of scarce resources. (23) The ability to recognise serious illness and to perform common emergency and life-saving procedures, including caring for the unconscious patient and cardiopulmonary resuscitation. (15) The ability to choose, from the repertoire of clinical skills, those that are appropriate and practical to apply in a given situation. (16) The ability to interpret and integrate the history and physical examination findings to arrive at an appropriate diagnosis or differential diagnosis. (4) Common diagnostic procedures, their uses and limitations. (17) The ability to select the most appropriate and cost effective diagnostic procedures. (18) The ability to interpret common diagnostic procedures. (5) Management of common conditions including pharmacological, physical, nutritional and psychological therapies. A more detailed knowledge of management is required for those conditions that require urgent assessment and treatment. (19) The ability to formulate a management plan, and to plan management in concert with the patient.

Predominately

acquired in

settings other than

clinical settings.

Requires some

degree of

clinical setting.

Predominately

acquired in clinical

settings.

Attr

ibut

e 19

& 5

App

endi

x F

Med

ical

Dea

ns’ C

ompe

tenc

ies

Pro

ject

Fin

al R

epor

t

Feb

ruar

y 20

11

A

ttrib

ute

S

tude

nt L

earn

ing

Out

com

es

Com

pete

ncie

s

(5)

Man

agem

ent o

f com

mon

co

nditi

ons

incl

udin

g ph

arm

acol

ogic

al, p

hys

ical

, nu

triti

onal

and

psy

chol

ogic

al

ther

apie

s. A

mor

e de

taile

d kn

owle

dge

of m

anag

emen

t is

requ

ired

for

thos

e co

nditi

ons

that

re

quire

urg

ent a

sses

smen

t and

tr

eatm

ent.

1. T

he s

tude

nt h

as th

e ab

ility

to

unde

rsta

nd a

nd w

here

app

ropr

iate

app

ly

the

man

agem

ent o

f com

mon

con

ditio

ns

incl

udin

g th

e us

e of

pha

rmac

olog

ical

, ph

ysic

al, n

utrit

iona

l and

psy

chol

ogic

al

ther

apie

s.

2. T

he s

tude

nt h

as th

e ab

ility

to id

entif

y an

d m

anag

e th

ose

cond

ition

s w

hich

re

quire

urg

ent a

sses

smen

t and

trea

tmen

t. A

lso

refe

r to

attr

ibut

e 19

1.

Iden

tifie

s a

rang

e of

man

agem

ent o

ptio

ns in

clud

ing

phar

mac

olog

ical

, ph

ysic

al, n

utrit

iona

l and

psy

chol

ogic

al th

erap

ies

avai

labl

e to

man

age

com

mon

con

ditio

ns.

2.

Id

entif

ies,

ass

esse

s an

d tr

eats

com

mon

con

ditio

ns w

hich

req

uire

urg

ent

man

agem

ent.

Als

o re

fer

to a

ttrib

ute

19

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

mes

C

ompe

tenc

ies

(1

9) T

he a

bilit

y to

form

ulat

e a

man

agem

ent p

lan,

and

to p

lan

man

agem

ent i

n co

ncer

t with

a

patie

nt.

1. T

he s

tude

nt h

as th

e ab

ility

to fo

rmul

ate

an a

ppro

pria

te m

anag

emen

t pla

n.

2. T

he s

tude

nt h

as th

e ab

ility

to in

clud

e pa

tient

pre

fere

nces

in th

e fo

rmul

atio

n of

a

man

agem

ent p

lan.

1.

Iden

tifie

s th

e di

agno

ses/

issu

es r

equi

ring

man

agem

ent.

2.

E

xpla

ins

diag

nose

s/is

sues

or

pres

entin

g pr

oble

m to

the

patie

nt.

3.

Sel

ects

the

mos

t app

ropr

iate

man

agem

ent o

ptio

n(s)

and

form

ulat

es a

m

anag

emen

t pla

n in

con

cert

with

the

patie

nt.

4.

Iden

tifie

s in

form

atio

n, c

omm

unity

res

ourc

es a

nd o

ther

res

ourc

es w

hich

co

uld

assi

st w

ith th

e m

anag

emen

t pla

n.

5.

Com

mun

icat

es c

lear

sta

tem

ents

reg

ardi

ng th

e ne

xt s

tep;

incl

udin

g in

vest

igat

ions

, tre

atm

ent,

inte

rven

tions

and

pla

ns r

egar

ding

con

tinui

ty o

f ca

re.

6.

Dem

onst

rate

s so

und

com

mun

icat

ion

skill

s al

low

ing

the

iden

tific

atio

n of

pa

tient

pre

fere

nces

and

incl

usio

n th

roug

h ne

gotia

tion

of th

ose

proc

edur

es in

to th

e fin

al p

lan.

7.

D

emon

stra

tes

know

ledg

e of

the

impa

ct o

f diff

eren

t cul

tura

l, so

cial

, re

ligio

us a

nd li

ngui

stic

bac

kgro

unds

on

man

agem

ent p

lans

.

Attr

ibut

e 18

, 17

& 4

App

endi

x F

M

edic

al D

eans

’ Com

pete

ncie

s P

roje

ct

F

inal

Rep

ort

Feb

ruar

y 20

11

A

ttrib

ute

S

tude

nt L

earn

ing

Out

com

es

Com

pete

ncie

s

(17)

The

abi

lity

to s

elec

t the

mos

t ap

prop

riate

and

cos

t effe

ctiv

e di

agno

stic

pro

cedu

res.

1.

The

stu

dent

has

the

abili

ty to

sel

ect t

he m

ost a

ppro

pria

te

diag

nost

ic p

roce

dure

for

the

patie

nt.

2.

The

stu

dent

has

the

abili

ty to

sel

ect t

he m

ost c

ost

ef

fect

ive

diag

nost

ic p

roce

dure

for

the

patie

nt.

3.

The

stu

dent

has

the

abili

ty to

org

anis

e or

col

lect

the

spec

imen

s fo

r th

e m

ost a

ppro

pria

te d

iagn

ostic

pr

oced

ure.

1.

Kno

ws

and

expl

ains

the

com

mon

dia

gnos

tic

proc

edur

es li

sted

in A

ppen

dix

A.

2.

Und

erst

ands

the

clin

ical

indi

catio

ns fo

r th

e us

e of

co

mm

on d

iagn

ostic

pro

cedu

res.

3.

Id

entif

ies

the

cost

s an

d be

nefit

s of

pot

entia

l di

agno

stic

pro

cedu

res

in a

giv

en c

linic

al

situ

atio

n/sc

enar

io.

4.

Sel

ects

the

mos

t app

ropr

iate

dia

gnos

tic p

roce

dure

to

ass

ist i

n th

e fo

rmul

atio

n of

a d

iagn

osis

and

pa

tient

man

agem

ent.

5.

Org

anis

es p

roce

dure

s or

col

lect

s sa

mpl

es/s

peci

men

s fo

r di

agno

stic

test

ing.

A

ttrib

ute

S

tude

nt L

earn

ing

Out

com

es

Com

pete

ncie

s

(4)

Com

mon

dia

gnos

tic

proc

edur

es th

eir

uses

and

lim

itatio

ns.

1. T

he s

tude

nt h

as th

e ab

ility

to u

nder

stan

d an

d ex

plai

n co

mm

on d

iagn

ostic

pro

cedu

res

and

thei

r lim

itatio

ns.

Als

o re

fer

to a

ttrib

utes

17

& 1

8

Als

o re

fer

to a

ttrib

utes

17

& 1

8

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

mes

C

ompe

tenc

ies

(18)

The

abi

lity

to in

terp

ret

com

mon

dia

gnos

tic p

roce

dure

s.

1.

The

stu

dent

has

the

abili

ty to

inte

rpre

t com

mon

di

agno

stic

pro

cedu

res

for

a pa

tient

.

1.

Inte

rpre

ts th

e re

sults

of c

omm

on d

iagn

ostic

pr

oced

ures

list

ed in

App

endi

x A

.

2.

App

lies

the

conc

ept o

f spe

cific

ity, s

ensi

tivity

, pre

an

d po

st te

st p

roba

bilit

y to

the

inte

rpre

tatio

n of

co

mm

on d

iagn

ostic

pro

cedu

res.

3

. In

tegr

ates

res

ults

of c

omm

on d

iagn

ostic

pr

oced

ures

with

clin

ical

info

rmat

ion

to in

form

and

en

hanc

e m

anag

emen

t.

Attr

ibut

e 16

& 1

5

App

endi

x F

Med

ical

Dea

ns’ C

ompe

tenc

ies

Pro

ject

F

inal

Rep

ort

Feb

ruar

y 20

11

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

mes

C

ompe

tenc

ies

(1

6) T

he a

bilit

y to

inte

rpre

t and

inte

grat

e th

e hi

stor

y an

d ph

ysic

al e

xam

inat

ion

findi

ngs

to a

rriv

e at

an

appr

opria

te d

iagn

osis

or

diffe

rent

ial

diag

nosi

s.

1.

The

stu

dent

has

the

abili

ty to

con

duct

a p

atie

nt

inte

rvie

w.

2.

The

stu

dent

has

the

abili

ty to

per

form

a

stru

ctur

ed p

robl

em fo

cuse

d ph

ysic

al

exam

inat

ion.

3.

T

he s

tude

nt h

as th

e ab

ility

to in

tegr

ate

info

rmat

ion

obta

ined

from

a p

atie

nt in

terv

iew

an

d ph

ysic

al e

xam

inat

ion.

4.

T

he s

tude

nt h

as th

e ab

ility

to in

tegr

ate

info

rmat

ion

and

to u

tilis

e cl

inic

al r

easo

ning

to

arriv

e at

a d

iagn

osis

and

diff

eren

tial d

iagn

osis

.

1.

Con

duct

s a

prob

lem

focu

sed,

str

uctu

red

clin

ical

inte

rvie

w.

2.

E

licits

info

rmat

ion

for

the

purp

oses

of a

pat

ient

hi

stor

y fr

om th

e pa

tient

, rel

ativ

es, p

erso

ns

pres

ent f

or th

e in

terv

iew

. 3.

C

ondu

cts

a pr

oble

m fo

cuse

d st

ruct

ured

ph

ysic

al e

xam

inat

ion.

4.

C

ondu

cts

a w

hole

per

son

phys

ical

ex

amin

atio

n or

org

an(s

)/sy

stem

spe

cific

ph

ysic

al e

xam

inat

ion

as a

ppro

pria

te.

5.

Inte

grat

es th

e in

form

atio

n ob

tain

ed to

arr

ive

at

an a

ppro

pria

te d

iagn

osis

and

diff

eren

tial

diag

nosi

s.

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

mes

C

ompe

tenc

ies

(1

5) T

he a

bilit

y to

cho

ose

from

the

repe

rtoi

re o

f cl

inic

al s

kills

, tho

se th

at a

re a

ppro

pria

te a

nd

prac

tical

to a

pply

in a

giv

en s

ituat

ion.

1.

The

stu

dent

has

the

abili

ty to

per

form

a r

ange

of

dia

gnos

tic a

nd th

erap

eutic

clin

ical

ski

lls.

2.

The

stu

dent

has

the

abili

ty to

ana

lyse

a c

linic

al

pres

enta

tion

and

sele

ct a

ppro

pria

te c

linic

al

skill

s fo

r th

e si

tuat

ion.

1.

Ana

lyse

s th

e cl

inic

al p

rese

ntat

ion

and

dete

rmin

es th

e re

quire

d cl

inic

al s

kills

.

2.

Per

form

s di

agno

stic

and

ther

apeu

tic c

linic

al

skill

s as

list

ed in

App

endi

x B

.

3.

Rec

ogni

ses

the

limits

of h

is/h

er c

linic

al s

kills

. 4.

R

ecog

nise

s th

e lim

its o

f his

/her

aut

horit

y.

Attr

ibut

e 23

& 3

2

App

endi

x F

Med

ical

Dea

ns’ C

ompe

tenc

ies

Pro

ject

Fin

al R

epor

t

F

ebru

ary

2011

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

me

s C

ompe

tenc

ies

(2

3) T

he a

bilit

y to

rec

ogni

se s

erio

us il

lnes

s an

d to

pe

rfor

m c

omm

on e

mer

genc

y an

d lif

e sa

ving

pr

oced

ures

, inc

ludi

ng c

arin

g fo

r th

e un

cons

ciou

s pa

tient

and

car

diop

ulm

onar

y re

susc

itatio

n.

1.

The

stu

dent

has

the

abili

ty to

rec

ogni

se

serio

us il

lnes

s.

2.

The

stu

dent

has

the

abili

ty to

per

form

com

mon

lif

e sa

ving

and

em

erge

ncy

proc

edur

es.

3.

The

stu

dent

has

the

abili

ty to

per

form

ca

rdio

pulm

onar

y re

susc

itatio

n.

4.

The

stu

dent

has

the

abili

ty to

car

e fo

r th

e un

cons

ciou

s pa

tient

.

1.

Iden

tifie

s th

e si

gns

and

sym

ptom

s of

ser

ious

ill

ness

.

2.

Und

erst

ands

and

whe

re a

ppro

pria

te p

erfo

rms

life

savi

ng a

nd e

mer

genc

y pr

oced

ures

in

dica

ted

in A

ppen

dix

B.

3.

Acc

urat

ely

perf

orm

s ca

rdio

pulm

onar

y re

susc

itatio

n.

4.

App

ropr

iate

ly c

ares

for

the

unco

nsci

ous

patie

nt.

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

mes

C

ompe

tenc

ies

(3

2) A

n ap

prec

iatio

n of

the

com

plex

ity o

f eth

ical

is

sues

rel

ated

to h

uman

life

and

dea

th, i

nclu

ding

th

e al

loca

tion

of s

carc

e re

sour

ces.

1. T

he s

tude

nt h

as th

e ab

ility

to u

nder

stan

d an

d re

spon

d to

eth

ical

issu

es r

elat

ing

to h

uman

life

and

de

ath.

2.

The

stu

dent

has

the

abili

ty to

und

erst

and

the

impl

icat

ions

of r

esou

rce

cons

trai

nts

on p

atie

nt

care

.

1.

Iden

tifie

s et

hica

l com

plex

ities

in r

elat

ion

to li

fe

and

deat

h sc

enar

ios.

2.

Iden

tifie

s th

e et

hica

l iss

ues

pert

aini

ng to

: ad

vanc

ed c

are

dire

ctiv

es, w

ithdr

awal

or

refu

sal o

f tre

atm

ent a

nd o

rgan

don

atio

n.

3.

Und

erst

ands

pot

entia

l res

pons

es to

eth

ical

di

lem

mas

in c

linic

al s

cena

rios

. 4.

U

nder

stan

ds p

oten

tial i

mpa

cts

of r

esou

rce

cons

trai

nt o

n pa

tient

car

e.

Attr

ibut

e 14

& 1

3

App

endi

x F

Med

ical

Dea

ns’ C

ompe

tenc

ies

Pro

ject

Fin

al R

epor

t

F

ebru

ary

2011

A

ttrib

ute

S

tude

nt L

earn

ing

Out

com

es

Com

pete

ncie

s

(13)

The

abi

lity

to c

onst

ruct

in

cons

ulta

tion

with

a p

atie

nt, a

n ac

cura

te,

orga

nise

d an

d pr

oble

m fo

cuse

d m

edic

al

hist

ory.

1.

The

stu

dent

has

the

abili

ty to

con

duct

an

orga

nise

d an

d pr

oble

m fo

cuse

d pa

tient

in

terv

iew

to o

btai

n a

rele

vant

med

ical

hi

stor

y.

1.

Tak

es a

rel

evan

t, lo

gica

l and

com

preh

ensi

ve h

isto

ry.

2.

App

lies

the

key

com

pone

nts

of th

e pa

tient

his

tory

dur

ing

the

clin

ical

inte

rvie

w.

3.

Com

mun

icat

es e

ffect

ivel

y fo

r th

e pu

rpos

es o

f con

duct

ing

a cl

inic

al in

terv

iew

. 4.

E

licits

rel

evan

t life

styl

e, o

ccup

atio

nal,

soci

al a

nd fa

mily

his

tory

w

hils

t con

duct

ing

a cl

inic

al in

terv

iew

. 5.

T

ailo

rs q

uest

ions

in th

e cl

inic

al in

terv

iew

acc

ordi

ng to

kn

owle

dge

of s

ympt

oms

of c

omm

on m

edic

al c

ondi

tions

. 6.

D

ispl

ays

resp

ect a

nd e

mpa

thy

for

the

patie

nt d

urin

g a

clin

ical

in

terv

iew

.

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

me

s C

ompe

tenc

ies

(1

4) T

he a

bilit

y to

per

form

an

accu

rate

ph

ysic

al a

nd m

enta

l sta

te e

xam

inat

ion.

1.

T

he s

tude

nt h

as th

e ab

ility

to p

erfo

rm a

n ac

cura

te p

hys

ical

exa

min

atio

n.

2.

The

stu

dent

has

the

abili

ty to

con

duct

an

accu

rate

men

tal s

tate

exa

min

atio

n.

1.

Con

duct

s a

who

le p

erso

n ph

ysic

al e

xam

inat

ion.

2.

Con

duct

s an

acc

urat

e ph

ysic

al e

xam

inat

ion.

3.

Con

duct

s a

prob

lem

focu

sed

stru

ctur

ed p

hys

ical

exa

min

atio

n.

4.

Dem

onst

rate

s th

e ab

ility

to c

ondu

ct a

n or

gan(

s)/s

yste

m

spec

ific

phys

ical

exa

min

atio

n as

app

ropr

iate

. 5.

C

ondu

cts

an a

ccur

ate

men

tal s

tate

exa

min

atio

n.

6.

Sho

ws

resp

ect,

expl

ains

the

proc

ess,

gai

ns c

onse

nt a

nd

mai

ntai

ns p

atie

nt d

igni

ty w

hile

per

form

ing

a ph

ysic

al o

r m

enta

l st

ate

exam

inat

ion.

7.

R

ecog

nise

s w

hen

a fa

mily

mem

ber

or a

cha

pero

ne s

houl

d be

pr

esen

t for

a p

hysi

cal o

r m

enta

l sta

te e

xam

inat

ion.

Attr

ibut

e 11

& 3

9

App

endi

x F

Med

ical

Dea

ns’ C

ompe

tenc

ies

Pro

ject

F

inal

Rep

ort

Feb

ruar

y 20

11

A

ttrib

ute

S

tude

nt L

earn

ing

Out

com

es

Com

pete

ncie

s

(39)

A p

repa

redn

ess

to

wor

k ef

fect

ivel

y in

a te

am

with

oth

er h

ealth

car

e pr

ofes

sion

als.

1.

The

stu

dent

has

an

abili

ty to

und

erst

and,

res

pect

and

in

corp

orat

e th

e ro

les

of o

ther

hea

lth p

rofe

ssio

nals

in

heal

th c

are.

2.

T

he s

tude

nt h

as a

n ab

ility

to w

ork

effe

ctiv

ely

in a

team

w

ith o

ther

hea

lthca

re p

rofe

ssio

nals

.

3.

The

stu

dent

has

the

abili

ty to

und

erst

and

his/

her

role

in a

te

am w

ith o

ther

hea

lth p

rofe

ssio

nals

.

1.

Iden

tifie

s an

d ac

ts u

pon

his/

her

role

in a

hea

lth c

are

team

.

2.

Iden

tifie

s ro

les

of o

ther

hea

lth p

rofe

ssio

nals

in a

hea

lth

care

team

.

3.

Dis

play

s pr

ofes

sion

al c

ourt

esy

for

othe

r he

alth

car

e pr

ofes

sion

als

in a

hea

lth c

are

team

. 4.

C

ontr

ibut

es to

team

wor

k by

beh

avin

g in

wa

ys w

hich

m

axim

ises

the

team

’s e

ffect

iven

ess.

• A

ttrib

ute

39 h

as b

een

iden

tifie

d by

the

Writ

ing

Gro

up a

s re

quiri

ng r

evis

ed b

y th

e A

MC

. .

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

me

s C

ompe

tenc

ies

(1

1) In

dige

nous

hea

lth,

incl

udin

g th

e hi

stor

y,

cultu

ral d

evel

opm

ent a

nd

heal

th o

f the

Indi

geno

us

peop

les

of A

ustr

alia

and

N

ew Z

eala

nd.

1.

The

stu

dent

is a

war

e of

, and

abl

e to

rel

ate

to, t

he fa

ctor

s w

hich

con

trib

ute

to th

e st

atus

of I

ndig

enou

s he

alth

. 2.

T

he s

tude

nt u

nder

stan

ds th

at c

ultu

re is

impo

rtan

t to

Indi

geno

us p

eopl

e an

d ca

n af

fect

thei

r he

alth

and

sen

se

of w

ell-b

eing

. 3.

T

he s

tude

nt u

nder

stan

ds A

ustr

alia

n/N

ew Z

eala

nd h

isto

ry

and

is a

war

e of

the

expe

rienc

e of

Indi

geno

us p

eopl

es a

nd

how

this

impa

cts

on In

dige

nous

hea

lth a

nd h

ealth

car

e.

4.

The

stu

dent

und

erst

ands

the

dive

rsity

of I

ndig

enou

s cu

lture

s, e

xper

ienc

es a

nd c

omm

uniti

es.

1.

App

lies

an u

nder

stan

ding

of I

ndig

enou

s m

orta

lity

and

mor

bidi

ty p

atte

rns

and

thei

r im

pact

as

wel

l as

reco

gnis

ing

issu

es a

ssoc

iate

d w

ith a

cces

s to

hea

lth c

are.

2.

D

emon

stra

tes

a w

orki

ng k

now

ledg

e of

the

soci

al

dete

rmin

ants

of I

ndig

enou

s he

alth

incl

udin

g th

e im

pact

of

colo

nisa

tion,

life

styl

e, n

utrit

ion,

soc

ioec

onom

ic fa

ctor

s,

geog

raph

y an

d ac

cess

to h

ousi

ng, e

duca

tion

and

heal

th

care

. 3.

C

onsi

ders

the

hist

oric

al, c

ultu

ral,

soci

al a

nd p

oliti

cal

fact

ors

whi

ch im

pact

on

the

heal

th o

f an

Indi

geno

us

patie

nt.

4.

Dem

onst

rate

s a

sens

itive

and

res

pect

ful a

ppro

ach

whe

n in

tera

ctin

g w

ith In

dige

nous

peo

ple

/ pat

ient

s an

d pr

actic

es w

ith th

e kn

owle

dge

that

Indi

geno

us c

ultu

res

are

dive

rse.

5.

P

lans

and

pro

vide

s ca

re in

a c

ompr

ehen

sive

and

cu

ltura

lly s

ecur

e w

ay.

Attr

ibut

e 37

& 2

2

App

endi

x F

M

edic

al D

eans

’ Com

pete

ncie

s P

roje

ct

F

inal

Rep

ort

Feb

ruar

y 20

11

A

ttrib

ute

S

tude

nt L

earn

ing

Ou

tcom

es

Com

pete

ncie

s

(22)

The

abi

lity

to c

ouns

el p

atie

nts

sens

itive

ly a

nd

effe

ctiv

ely,

and

to p

rovi

de in

form

atio

n in

a m

anne

r th

at e

nsur

es p

atie

nts

and

fam

ilies

can

be

fully

in

form

ed w

hen

cons

entin

g to

an

y pr

oced

ures

.

1. T

he s

tude

nt h

as th

e ab

ility

to c

ouns

el p

atie

nts

sens

itive

ly a

nd e

ffect

ivel

y.

2. T

he s

tude

nt h

as th

e ab

ility

to c

usto

mis

e in

form

atio

n to

mee

t the

req

uire

men

ts o

f pat

ient

s an

d fa

mili

es.

3. T

he s

tude

nt h

as th

e ab

ility

to o

btai

n in

form

ed

cons

ent f

rom

pat

ient

s, fa

mili

es a

nd o

ther

s as

re

quire

d.

1.

Em

path

ises

with

and

sho

ws

com

pass

ion

tow

ards

pat

ient

s an

d th

eir

fam

ilies

.

2.

Effe

ctiv

ely

com

mun

icat

es w

hils

t cou

nsel

ling

patie

nts.

3.

Iden

tifie

s ho

w a

nd w

here

to s

ourc

e ap

prop

riate

info

rmat

ion

for

patie

nts

and

thei

r fa

mili

es.

4.

P

rovi

des

rele

vant

info

rmat

ion

and

optio

ns,

cont

extu

alis

ed to

the

circ

umst

ance

s of

pa

tient

s an

d th

eir

fam

ilies

.

5.

Exp

lain

s m

anag

emen

t opt

ions

for

the

purp

oses

of i

nfor

med

con

sent

.

6.

Exp

lain

s ad

vers

e ef

fect

s, r

isks

, ben

efits

and

po

ssib

le o

utco

mes

of a

pro

cedu

re to

a p

atie

nt

for

the

purp

oses

of i

nfor

med

con

sent

.

7.

Ens

ures

that

pat

ient

s an

d th

eir

fam

ilies

are

fu

lly in

form

ed w

hen

cons

entin

g to

m

anag

emen

t opt

ions

.

8.

Doc

umen

ts p

atie

nt c

onse

nt.

• A

ttrib

ute

22 h

as b

een

iden

tifie

d by

the

Writ

ing

Gro

up a

s an

attr

ibut

e th

at c

ould

be

revi

sed

by th

e A

MC

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

mes

C

ompe

tenc

ies

(3

7) A

com

mitm

ent t

o co

mm

unic

atin

g w

ith p

atie

nts

and

thei

r fa

mili

es, a

nd to

invo

lvin

g th

em fu

lly in

pl

anni

ng m

anag

emen

t.

1. T

he s

tude

nt h

as th

e ab

ility

to c

omm

unic

ate

effe

ctiv

ely

with

a p

atie

nt in

volv

ing

them

fully

in

plan

ning

man

agem

ent i

n a

rang

e of

set

tings

. 2.

The

stu

dent

has

the

abili

ty to

app

ropr

iate

ly

invo

lve

and

com

mun

icat

e w

ith fa

mily

mem

bers

an

d ot

hers

in m

anag

emen

t pla

ns.

1.

Dem

onst

rate

s so

und

com

mun

icat

ion

skill

s al

low

ing

the

iden

tific

atio

n an

d in

clus

ion

of

patie

nt a

nd fa

mily

pre

fere

nces

in th

e m

anag

emen

t pla

n.

2.

In

corp

orat

es k

now

ledg

e of

diff

eren

t cul

tura

l, so

cial

, rel

igio

us a

nd li

ngui

stic

bac

kgro

unds

in

com

mun

icat

ing

man

agem

ent p

lans

to p

atie

nts

and

thei

r fa

mili

es.

Attr

ibut

e 21

& 2

0

App

endi

x F

Med

ical

Dea

ns’ C

ompe

tenc

ies

Pro

ject

Fin

al R

epor

t

F

ebru

ary

2011

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

mes

C

ompe

tenc

ies

(2

1) T

he s

kills

nee

ded

to w

ork

safe

ly a

s an

inte

rn, a

s ou

tline

d in

th

e N

atio

nal P

atie

nt S

afet

y E

duca

tion

Fra

mew

ork

deve

lope

d by

the

Aus

tral

ian

Cou

ncil

for

Qua

lity

and

Saf

ety

in H

ealth

Car

e.

1.

The

stu

dent

has

the

abili

ty to

wor

k sa

fely

.

2.

The

stu

dent

has

the

abili

ty to

app

ly th

e re

leva

nt

skill

s of

the

Nat

iona

l Pat

ient

Saf

ety

Edu

catio

nal

Fra

mew

ork

appr

opria

te fo

r a

doct

or c

omm

enci

ng

inte

rnsh

ip.

The

re w

ill b

e a

link

crea

ted

in th

e m

ind

map

fram

ewor

k to

th

e N

atio

nal P

atie

nt S

afet

y E

duca

tion

Fra

mew

ork.

To

be d

eter

min

ed

Attr

ibut

e 21

nee

ds to

be

take

n ou

t and

wor

ked

on b

y a

noth

er g

roup

.

A

ttrib

ute

S

tude

nt L

earn

ing

Out

com

es

Com

pete

ncie

s

(20)

Com

mun

icat

ion

skill

s,

incl

udin

g be

ing

able

to li

sten

and

re

spon

d, a

s w

ell a

s be

ing

able

to

conv

ey

info

rmat

ion

clea

rly,

cons

ider

atel

y an

d se

nsiti

vely

to

patie

nts

and

thei

r fa

mili

es, d

octo

rs,

nurs

es, o

ther

hea

lth p

rofe

ssio

nals

an

d th

e ge

nera

l pub

lic.

1. T

he s

tude

nt h

as th

e ab

ility

to c

omm

unic

ate

effe

ctiv

ely

with

pat

ient

s an

d fa

mili

es in

a r

ange

of s

ettin

gs.

2. T

he s

tude

nt h

as th

e ab

ility

to c

omm

unic

ate

effe

ctiv

ely

with

oth

er h

ealth

pro

fess

iona

ls a

nd th

e ge

nera

l pub

lic.

1.

List

ens

and

resp

onds

em

path

etic

ally

usi

ng v

erba

l, no

n ve

rbal

and

writ

ten

form

ats.

2.

Rec

ogni

ses

and

deal

s w

ith b

arrie

rs to

effe

ctiv

e co

mm

unic

atio

n in

a r

ange

of s

ettin

gs.

3.

C

omm

unic

ates

pro

fess

iona

lly a

nd c

onsi

dera

tely

with

the

heal

th c

are

team

for

optim

al p

atie

nt o

utco

mes

.

4.

Inte

ract

s pr

ofes

sion

ally

with

the

gene

ral p

ublic

.

Attr

ibut

e 6

App

endi

x F

Med

ical

Dea

ns’ C

ompe

tenc

ies

Pro

ject

F

inal

Rep

ort

Feb

ruar

y 20

11

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

mes

C

ompe

tenc

ies

(6

) N

orm

al p

regn

ancy

and

chi

ldbi

rth,

the

mor

e co

mm

on o

bste

tric

al e

mer

genc

ies,

the

prin

cipl

es o

f ant

enat

al a

nd p

ostn

atal

car

e,

and

med

ical

asp

ects

of f

amily

pla

nnin

g.

1. T

he s

tude

nt h

as th

e ab

ility

to u

nder

stan

d no

rmal

pr

egna

ncy

and

child

birt

h.

2. T

he s

tude

nt h

as th

e ab

ility

to a

pply

kno

wle

dge

rega

rdin

g th

e m

ore

com

mon

obs

tetr

ical

em

erge

ncie

s.

3. T

he s

tude

nt h

as th

e ab

ility

to a

pply

the

prin

cipl

es o

f an

tena

tal a

nd p

ostn

atal

car

e.

4. T

he s

tude

nt h

as th

e ab

ility

to e

xpla

in th

e m

edic

al

aspe

cts

of fa

mily

pla

nnin

g.

1.

Exp

lain

s no

rmal

pre

gnan

cy a

nd c

hild

birt

h.

2.

P

artic

ipat

es u

nder

sup

ervi

sion

in th

e m

anag

emen

t of a

nor

mal

chi

ldbi

rth.

3.

E

xpla

ins

the

mor

e co

mm

on o

bste

tric

al

emer

genc

ies

incl

udin

g pa

in a

nd b

leed

ing.

4.

E

xpla

ins

the

prin

cipl

es o

f ant

enat

al c

are.

5.

E

xpla

ins

the

prin

cipl

es o

f pos

tnat

al c

are.

6.

C

omm

unic

ates

effe

ctiv

ely

with

pat

ient

s in

re

gard

s to

the

med

ical

asp

ects

of f

amily

pl

anni

ng in

clud

ing

advi

ce o

n co

ntra

cept

ion,

fe

rtili

ty a

nd d

ealin

g w

ith a

n un

wan

ted

preg

nanc

y.

Attr

ibut

e 8

A

ppen

dix

F

Med

ical

Dea

ns’ C

ompe

tenc

ies

Pro

ject

F

inal

Rep

ort

Feb

ruar

y 20

11

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

mes

C

ompe

tenc

ies

(8

) T

he p

rinci

ples

of

amel

iora

tion

of s

uffe

ring

and

disa

bilit

y, r

ehab

ilita

tion

and

care

of t

he d

ying

.

1. T

he s

tude

nt h

as th

e ab

ility

to u

nder

stan

d an

d am

elio

rate

suf

ferin

g.

2. T

he s

tude

nt h

as th

e ab

ility

to u

nder

stan

d an

d ap

ply

the

prin

cipl

es o

f man

agin

g di

sabi

lity.

3.

The

stu

dent

has

the

abili

ty to

und

erst

and

and

appl

y th

e pr

inci

ples

of r

ehab

ilita

tion.

4.

The

stu

dent

has

the

abili

ty to

und

erst

and

and

appl

y th

e pr

inci

ples

for

care

of t

he d

ying

.

1.

Con

trib

utes

as

a te

am m

embe

r in

the

man

agem

ent o

f suf

ferin

g,

disa

bilit

y, r

ehab

ilita

tion

and

care

of t

he d

ying

.

2.

Und

erst

ands

and

app

lies

the

prin

cipl

es o

f am

elio

ratio

n of

suf

ferin

g.

3.

P

rovi

des

peop

le w

ith a

dis

abili

ty w

ith th

e re

sour

ces

and

info

rmat

ion

requ

ired

to a

ttain

inde

pend

ence

and

sel

f det

erm

inat

ion.

4.

Und

erst

ands

and

app

lies

the

prin

cipl

es o

f reh

abili

tatio

n in

clud

ing

enab

ling

peop

le to

mai

ntai

n or

ach

ieve

thei

r op

timal

phy

sica

l, se

nsor

y, in

telle

ctua

l, so

cial

and

psy

chol

ogic

al fu

nctio

ning

leve

ls.

5.

U

nder

stan

ds a

nd a

pplie

s th

e pr

inci

ples

of p

allia

tive

care

incl

udin

g sy

mpt

om r

elie

f and

psy

chol

ogic

al s

uppo

rt fo

r pa

tient

s an

d th

eir

fam

ily.

6.

U

nder

stan

ds a

nd a

pplie

s th

e pr

inci

ples

of e

nd o

f life

pla

nnin

g an

d ca

re.

7.

E

ngag

es w

ith p

atie

nts

and

thei

r fa

mili

es to

ass

ess

thei

r ne

eds

incl

udin

g or

gani

sing

app

ropr

iate

sup

port

and

ber

eave

men

t co

unse

lling

.

8.

Rec

ogni

ses

and

appr

ecia

tes

the

need

to c

all o

n ap

prop

riate

sup

port

s fo

r se

lf an

d ot

her

mem

bers

of t

he h

ealth

car

e te

am.

Attr

ibut

e 40

& 9

App

endi

x F

Med

ical

Dea

ns’ C

ompe

tenc

ies

Pro

ject

F

inal

Rep

ort

Feb

ruar

y 20

11

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

mes

C

ompe

tenc

ies

(4

0) A

rea

lisat

ion

that

one

’s o

wn

pers

onal

, sp

iritu

al, c

ultu

ral o

r re

ligio

us b

elie

fs s

houl

d no

t pr

even

t the

pro

visi

on o

f ade

quat

e an

d ap

prop

riate

in

form

atio

n to

the

patie

nt a

nd/o

r th

e pa

tient

’s

fam

ily, o

r th

e pr

ovis

ion

of a

ppro

pria

te

man

agem

ent i

nclu

ding

the

refe

rral

to a

noth

er

prac

titio

ner.

1. T

he s

tude

nt h

as th

e ab

ility

to r

ecog

nise

his

/her

ow

n pe

rson

al, s

pirit

ual,

cultu

ral o

r re

ligio

us v

alue

s.

2. T

he s

tude

nt h

as th

e ab

ility

to r

ealis

e th

at h

is/h

er

own

spiri

tual

, cul

tura

l or

relig

ious

bel

iefs

sho

uld

not p

reve

nt a

ppro

pria

te p

atie

nt m

anag

emen

t. 3.

The

stu

dent

has

the

abili

ty to

rea

lise

whe

n re

ferr

al to

ano

ther

pra

ctiti

oner

is a

ppro

pria

te.

1.

Iden

tifie

s hi

s/he

r ow

n pe

rson

al s

pirit

ual,

pers

onal

, cul

tura

l and

rel

igio

us b

elie

fs.

2.

C

omm

unic

ates

app

ropr

iate

info

rmat

ion

to

patie

nts

and

thei

r fa

mili

es ir

resp

ectiv

e of

hi

s/he

r ow

n be

liefs

. 3.

P

lans

app

ropr

iate

pat

ient

man

agem

ent

irres

pect

ive

of h

is/h

er o

wn

belie

fs.

4.

Ref

ers

to a

noth

er p

ract

ition

er w

hen

appr

opria

te.

Attr

ibu

te

Stu

dent

Lea

rnin

g O

utco

mes

C

ompe

tenc

ies

(9

) F

acto

rs a

ffect

ing

hum

an r

elat

ions

hips

, the

ps

ycho

logi

cal,

cultu

ral,

spiri

tual

wel

l-bei

ng o

f pa

tient

s an

d th

eir

fam

ilies

, and

the

inte

ract

ions

be

twee

n hu

man

s an

d th

eir

soci

al a

nd p

hys

ical

en

viro

nmen

ts.

1.

The

stu

dent

has

the

abili

ty to

und

erst

and

the

effe

ct th

at h

uman

rel

atio

nshi

ps h

ave

on a

pa

tient

’s h

ealth

.

2.

The

stu

dent

has

the

abili

ty to

und

erst

and

the

impa

ct o

f soc

ial a

nd p

hys

ical

env

ironm

ents

on

heal

th, i

nclu

ding

the

psyc

holo

gica

l, cu

ltura

l an

d sp

iritu

al w

ell b

eing

of p

atie

nts

and

thei

r fa

mili

es.

1.

Iden

tifie

s th

e ke

y fa

ctor

s in

hum

an

rela

tions

hips

that

can

affe

ct h

ealth

.

2.

Rec

ogni

ses

the

impo

rtan

ce o

f psy

chol

ogic

al,

cultu

ral a

nd s

pirit

ual w

ell b

eing

of p

atie

nts

and

thei

r fa

mili

es a

nd h

ow th

is c

ontr

ibut

es to

he

alth

.

3.

Rec

ogni

ses

the

impa

ct o

n a

patie

nt’s

hea

lth o

f th

eir

soci

al a

nd p

hys

ical

env

ironm

ent.

4.

Id

entif

ies

the

soci

al d

eter

min

ants

of i

ndiv

idua

l an

d po

pula

tion

heal

th in

clud

ing

risk

fact

ors.

5.

Dem

onst

rate

s cu

ltura

lly a

ppro

pria

te c

are.

Attr

ibut

e 25

& 2

8

App

endi

x F

Med

ical

Dea

ns’ C

ompe

tenc

ies

Pro

ject

Fin

al R

epor

t

F

ebru

ary

2011

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

mes

C

ompe

tenc

ies

(2

5) T

he a

bilit

y to

use

in

form

atio

n te

chno

log

y ap

prop

riate

ly a

s an

ess

entia

l re

sour

ce fo

r m

oder

n m

edic

al

prac

tice.

1.

The

stu

dent

has

the

abili

ty to

use

in

form

atio

n te

chno

log

y as

an

appr

opria

te r

esou

rce

for

acce

ssin

g qu

ality

and

up

to d

ate

info

rmat

ion.

2.

The

stu

dent

has

the

abili

ty to

use

in

form

atio

n te

chno

log

y fo

r op

timal

pat

ient

car

e.

1.

Effi

cien

tly a

cces

s re

leva

nt in

form

atio

n fo

r pa

tient

man

agem

ent,

rese

arch

and

on

goin

g pr

ofes

sion

al d

evel

opm

ent u

sing

info

rmat

ion

tech

nolo

gy.

2.

E

valu

ates

the

qual

ity a

nd r

elev

ance

of i

nfor

mat

ion

foun

d us

ing

info

rmat

ion

tech

nolo

gy.

3.

Pro

ficie

ntly

use

s av

aila

ble

elec

tron

ic p

atie

nt m

anag

emen

t sys

tem

s in

var

ious

he

alth

car

e se

tting

s.

4.

App

lies

info

rmat

ion

gain

ed to

opt

imis

e pa

tient

car

e.

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

me

s C

ompe

tenc

ies

(2

8) R

espe

ct fo

r ev

ery

hum

an

bein

g, in

clud

ing

resp

ect o

f se

xual

bou

ndar

ies.

1. T

he s

tude

nt h

as th

e ab

ility

to

disp

lay

resp

ect f

or e

very

hum

an

bein

g.

2. T

he s

tude

nt h

as th

e ab

ility

to

dem

onst

rate

res

pect

for

sexu

al

boun

darie

s.

Als

o re

fer

to a

ttrib

ute

14

1.

Tre

ats

patie

nts

with

dig

nity

at a

ll tim

es in

clud

ing

durin

g in

terv

iew

s an

d ph

ysic

al

exam

inat

ions

. 2.

R

espe

ct fo

r pa

tient

s se

xual

bou

ndar

ies

durin

g a

patie

nt in

terv

iew

and

a

phys

ical

exa

min

atio

n.

A

lso

refe

r to

attr

ibut

e 14

Attr

ibut

e 12

, 33

& 2

6

App

endi

x F

Med

ical

Dea

ns’ C

ompe

tenc

ies

Pro

ject

Fin

al R

epor

t

F

ebru

ary

2011

A

ttrib

ute

S

tude

nt L

earn

ing

Out

com

es

Com

pete

ncie

s

(33)

A r

ealis

atio

n th

at d

octo

rs e

ncou

nter

clin

ical

pr

oble

ms

that

exc

eed

thei

r kn

owle

dge

and

skill

s,

and

that

, in

thes

e si

tuat

ions

, the

y ne

ed to

con

sult

and/

or r

efer

the

patie

nt fo

r he

lp, i

n cl

inic

al, c

ultu

ral

soci

al a

nd la

ngua

ge r

elat

ed m

atte

rs a

s ap

prop

riate

.

1.

The

stu

dent

has

the

abili

ty to

rec

ogni

se w

hen

the

clin

ical

enc

ount

er e

xcee

ds h

is/h

er

know

ledg

e an

d sk

ill le

vel.

2.

The

stu

dent

has

the

abili

ty to

rec

ogni

se w

hen

the

y ne

ed to

ref

er o

r co

nsul

t with

ano

ther

pr

actit

ione

r.

3.

The

stu

dent

has

the

abili

ty to

rec

ogni

se w

hen

to r

efer

reg

ardi

ng c

linic

al, c

ultu

ral,

soci

al a

nd

lang

uage

rel

ated

mat

ters

.

1.

Kno

ws

his/

her

own

leve

l of s

kill

and

know

ledg

e.

2.

Ack

now

ledg

es w

hen

the

clin

ical

sce

nario

ex

ceed

s th

eir

leve

l of s

kill

and

know

ledg

e.

3.

C

onsu

lts a

nd c

omm

unic

ates

with

ano

ther

pr

actit

ione

r as

app

ropr

iate

.

4.

Ref

ers

to a

ppro

pria

te s

uppo

rt s

ervi

ces.

A

ttrib

ute

S

tude

nt L

earn

ing

Out

com

es

Com

pete

nci

es

(26)

Rec

ogni

tion

that

the

doct

or’s

prim

ary

prof

essi

onal

res

pons

ibili

ties

are

the

heal

th

inte

rest

s of

the

patie

nt a

nd th

e co

mm

unity

.

1.

The

stu

dent

has

the

abili

ty to

rec

ogni

se th

at

the

doct

or’s

prim

ary

prof

essi

onal

re

spon

sibi

litie

s ar

e th

e he

alth

inte

rest

s of

the

patie

nt a

nd th

e co

mm

unity

.

1.

Mak

es p

atie

nt c

are

his/

her

prim

ary

prof

essi

onal

res

pons

ibili

ty.

2.

U

nder

stan

ds th

e pr

ofes

sion

al r

espo

nsib

ility

of

the

doct

or e

xten

ds fr

om th

e in

divi

dual

pat

ient

to

the

heal

th in

tere

sts

of th

e co

mm

unity

.

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

mes

C

ompe

tenc

ies

(1

2) T

he p

rinci

ples

of e

thic

s re

late

d to

hea

lth c

are

and

the

lega

l res

pons

ibili

ties

of th

e m

edic

al

prof

essi

on.

1.

The

stu

dent

has

the

abili

ty to

und

erst

and

the

prin

cipl

es o

f eth

ics

as th

ey r

elat

e to

hea

lth

care

. 2.

T

he s

tude

nt h

as th

e ab

ility

to u

nder

stan

d th

e le

gal r

espo

nsib

ilitie

s of

the

med

ical

pro

fess

ion.

1.

Mai

ntai

ns e

thic

al a

nd le

gally

app

ropr

iate

st

anda

rds

at a

ll tim

es.

2.

U

nder

stan

ds th

e le

gal r

espo

nsib

ilitie

s of

hea

lth

prof

essi

onal

s es

peci

ally

thos

e re

latin

g to

in

form

ed c

onse

nt, d

uty

of c

are,

con

fiden

tialit

y an

d co

nflic

t of i

nter

est.

Attr

ibut

e 29

& 2

4

App

endi

x F

Med

ical

Dea

ns’ C

ompe

tenc

ies

Pro

ject

F

inal

Rep

ort

Feb

ruar

y 20

11

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

mes

C

ompe

tenc

ies

(2

9) R

espe

ct fo

r co

mm

unity

val

ues,

incl

udin

g an

ap

prec

iatio

n of

the

dive

rsity

of h

uman

bac

kgro

und

and

cultu

ral v

alue

s.

1. T

he s

tude

nt h

as th

e ab

ility

to r

espe

ct

com

mun

ity v

alue

s.

2. T

he s

tude

nt h

as th

e ab

ility

to a

ppre

ciat

e th

e di

vers

ity o

f hum

an b

ackg

roun

ds a

nd c

ultu

ral

valu

es.

Als

o re

fer

to a

ttrib

ute

28

1.

Res

pect

s al

l pat

ient

s, th

eir

fam

ilies

and

co

lleag

ues

rega

rdle

ss o

f age

, gen

der,

rac

e,

lang

uage

, cul

ture

, dis

abili

ty, r

elig

ion,

sex

ual

orie

ntat

ion

or e

cono

mic

sta

tus.

2.

Res

pect

s co

mm

unity

val

ues.

3.

App

reci

ates

div

ersi

ty o

f hum

an b

ackg

roun

ds.

4.

P

ract

ices

in a

cul

tura

lly s

afe

man

ner.

Als

o re

fer

to a

ttrib

ute

28

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

mes

C

ompe

tenc

ies

(2

4) T

he a

bilit

y to

inte

rpre

t med

ical

evi

denc

e in

a

criti

cal a

nd s

cien

tific

man

ner

and

an u

nder

stan

ding

of

the

epid

emio

log

y of

dis

ease

in d

iffer

ing

popu

latio

ns a

nd g

eogr

aphi

c lo

catio

ns.

1. T

he s

tude

nt h

as th

e ab

ility

to in

terp

ret m

edic

al

evid

ence

in a

crit

ical

and

sci

entif

ic m

anne

r.

2. T

he s

tude

nt h

as th

e ab

ility

to u

nder

stan

d th

e ep

idem

iolo

gy

of d

isea

se in

diff

erin

g po

pula

tions

an

d ge

ogra

phic

loca

tions

.

1.

Inte

rpre

ts m

edic

al e

vide

nce

in a

crit

ical

and

sc

ient

ific

man

ner.

2.

Und

erst

ands

how

dis

ease

affe

cts

diffe

ring

popu

latio

ns a

nd g

eogr

aphi

c lo

catio

ns.

3.

A

pplie

s ep

idem

iolo

gica

l dat

a in

man

agin

g th

e he

alth

of p

atie

nts

and

thei

r co

mm

uniti

es.

Attr

ibut

e 34

& 3

5

App

endi

x F

Med

ical

Dea

ns’ C

ompe

tenc

ies

Pro

ject

Fin

al R

epor

t

F

ebru

ary

2011

Attr

ibut

e

Stu

dent

Lea

rnin

g O

utco

me

s C

ompe

tenc

ies

(3

4) A

n ap

prec

iatio

n of

the

resp

onsi

bilit

y to

m

aint

ain

stan

dard

s of

med

ical

pra

ctic

e at

the

high

est p

ossi

ble

leve

l thr

ough

out a

pro

fess

iona

l ca

reer

.

1. T

he s

tude

nt h

as th

e ab

ility

to ta

ke r

espo

nsib

ility

to

mai

ntai

n st

anda

rds

of m

edic

al p

ract

ice

at th

e hi

ghes

t pos

sibl

e le

vel.

1.

Dem

onst

rate

s m

aint

enan

ce o

f hig

hest

pr

ofes

sion

al s

tand

ards

of m

edic

al p

ract

ice.

2.

D

emon

stra

tes

self

dire

cted

lear

ning

.

3.

Rec

ogni

ses

and

artic

ulat

es le

arni

ng g

oals

ar

isin

g fr

om c

linic

al s

cena

rios.

4.

Iden

tifie

s le

arni

ng a

ctiv

ities

that

will

ena

ble

him

/her

to a

ddre

ss le

arni

ng g

oals

. 5.

U

nder

take

s ap

prop

riate

lear

ning

act

iviti

es.

6.

See

ks fe

edba

ck fr

om p

eers

, tut

ors,

pat

ient

s an

d co

lleag

ues.

A

ttrib

ute

S

tude

nt L

earn

ing

Out

com

es

Com

pete

ncie

s

(35)

An

appr

ecia

tion

of th

e re

spon

sibi

lity

to

cont

ribut

e to

war

ds th

e ge

nera

tion

of k

now

ledg

e an

d th

e pr

ofes

sion

al e

duca

tion

of ju

nior

co

lleag

ues.

1. T

he s

tude

nt h

as th

e ab

ility

to c

ontr

ibut

e to

war

ds

the

gene

ratio

n of

kno

wle

dge.

2.

The

stu

dent

has

the

abili

ty to

con

trib

ute

tow

ards

th

e pr

ofes

sion

al e

duca

tion

of ju

nior

col

leag

ues.

1.

Par

ticip

ates

effe

ctiv

ely

in r

esea

rch

activ

ities

.

2.

Und

erta

kes

teac

hing

, inc

ludi

ng d

evel

opm

ent

of te

achi

ng s

kills

as

part

of p

rofe

ssio

nal

deve

lopm

ent.

3.

C

ontr

ibut

es to

the

prof

essi

onal

edu

catio

n of

pe

ers

and

juni

or c

olle

ague

s.

Diagnostic Procedures Appendix F

Medical Deans’ Competencies Project Final Report February 2011

Appendix A: List of Common Diagnostic Procedures as relates to Attribute 18 The student has the ability to interpret or understands:

• Electrocardiograms • Chest X-rays • Spiral CT • MRI • Ultrasound • Full Blood Counts, including liver function tests, urea, creatine and cardiac enzymes • Endocrine function tests including thyroid functioning, plasma glucose, urine albumin and

excretion rate in diabetics, serum cortisol, and serum parathyroid levels. • Observes endoscopic procedures including Upper GI, lower GI, colonoscopy and ERCP

procedures. • Interpretation of plain films, CT, Ultrasound and MRI with common medical surgical, obstetric,

gynaecological and paediatric conditions • Interpretation of doppler and duplex scans • Common haematology, biochemistry and microbiology tests • CT scanning, broncoscopy, fine needle aspiration biopsy, pleural tap and thoracoscopic

biopsy • Angiography • Blood gas measurements

Procedural Skills Appendix F

Medical Deans’ Competencies Project Final Report February 2011

Appendix B: Common Procedural Skills as relates to Attribute 15

EMERGENCY Performs Basic Life Support Performs Advanced Life Support Airway Management including management of the comatose patient Manage airway obstruction Administer Oxygen Provides Basic First Aid

GENERAL DOCTOR & PATIENT Interpret and perform Peak flow meter Interpret and perform Spirometry Perform and Interpret a resting ECG Performs blood pressure taking

EAR, NOSE AND THROAT Simple Ear, Nose and Throat examination Use an ophthalmoscope and a slit lamp Ophthalmoscope to examine for diabetic retinal changes Test for visual acuity Eyelid eversion Fluroscein - staining of cornea Pad eyes Removal of foreign body from eye Use of tuning forks Hearing loss tests Syringe an ear Insert an ear wick Use of a nasal speculum

GENERAL PROCEDURAL Performs Nasogastric tube insertion Performs IV cannulation Performs Venepuncture Collection and interpretation of Venous blood sample Collection and interpretation of Arterial blood sample Measures blood glucose Collects blood culture specimen using aseptic techniques Performs urinary catheterisation male and female Analyse a sample and read urinary dipsticks Performs a rectal examination Chest tube insertion Performs a lumbar puncture Simple swab using standard microbial collection Administer vaccinations

WOMEN’S HEALTH Performs a vaginal exam Performs a pap smear Collects urethral, vaginal and cervical swabs Performs a female breast examination

MUSCULOSKELETAL INJURY & ANAESTHESIA Performs suturing Plaster of the upper limb and lower limb Basic first aid techniques: splinting, slings, bandages and strapping. Application of a local anaesthetic Administer injections via Subcutaneous, Intramuscular or Intravenous methods Wound cleaning including debridement and wound dressing

Phone +61 2 9036 3363 Phone +61 2 9114 1680 Fax +61 2 9114 1722 Email admin@medicaldeans.org.au Level 6, 173 – 175 Phillip Street, Sydney NSW 2000

24 January 2011 To whom it concerns,

Endorsement of Medical Deans’ Competencies Project: Framework of Competencies for Graduate Outcomes which rely on clinical placements .

Medical Deans Australia and New Zealand Inc (Medical Deans) has undertaken a project, with funding from the Australian Government’s Department of Health and Ageing, to develop a framework of competencies for medical graduate outcomes which rely on clinical placements. The has project aimed to provide some precision around the purpose and content of clinical training in order to assist the continuing significant pressures on educational bodies and the Australian health system to be able to provide a sufficient number of high quality clinical training placements for the increased number of medical students. The Competencies Project has generated significant stakeholder interest and buy in throughout the project period. The project has achieved endorsement from a broad range of medical education groups, Medical Schools and the Deans. In particular, the Framework has achieved solid endorsement from Deans of Medical Schools with the project being acknowledged as beneficial for aiming to define graduate outcomes from clinical placements. Medical Deans endorses the Framework of Competencies for Graduate Outcomes which rely on Clinical Placements and supports further work developing the framework. Medical Deans looks forward to continuing the work of the Competencies Project in consultation with our stakeholders. Kind regards,

Professor James Angus President