Domain 2

Communication

HK Doctors Core Competences mapped to this domain:

Communication - Good communication skills underpin all aspects of the practice of medicine and medical graduates should be able to demonstrate effective verbal, non-verbal, written and electronic communication skills.

Medical informatics - Medical graduates should be competent in collecting, storing and using clinical data (from simple record-keeping to accessing and using computer-based data) and incorporate the use of health information technology in the day-to-day care of patients.

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Basic Training

Learning Outcomes
  1. Build and maintain functional relationships with CYP under one's care through effective communication.
  2. Engage in effective bi-directional verbal, non-verbal and written communication with CYP, their families, professionals and agencies in an accurate and respectful manner.
Key Capabilities
  1. Develop effective listening skills with social and cultural awareness and sensitivity.
  2. Keep good and accurate medical records.
  3. Hand over the care of patients through effective communication.
  4. Facilitate shared decision making with patients, families and carers.
  5. Take part in a multi-disciplinary team as a constructive member.
Illustrations
  1. Conduct out-patient clinical consultations and in-patient admissions by gathering and giving important and relevant information.
  2. Document clearly the history, physical findings, decision making process and communication in the medical records
  3. Write clear and effective medical reports, referral and reply letters.
  4. Handover patient care effectively through different means of communication.
  5. Participates effectively in MDT and engages with patients and families/carers, facilitating shared decision-making.
  6. Uses information technology effectively in daily practice
  7. Conduct effective interviews with CYP and families by empathetic listening and encouraging expression of the CYP and family.

 

Higher Training

Learning Outcomes
  • Apply effective communication skills in difficult settings, including handling complaints, patient interactions involving litigation, advance care plan and end-of-life management.
Key Capabilities
  1. Author legal documents and child protection reports.
  2. Foster team work approach and take a leading role in a MDT.
  3. Demonstrate to others how to manage an effective consultation, including communicating a diagnosis and prognosis effectively to children, young people and families.
Illustrations
  1. Create accurate and informative written pamphlets or information in a language suitable for the recipients for the purpose of obtaining consent or explaining the management plan.
  2. Makes appropriate referrals to statutory and voluntary agencies that provide support to CYP and their families.
  3. Write legal documents and child protection reports.
  4. Handle delicate communication, like breaking bad news, discussion of end-of-life care, with sensitivity and respect.

 

Opinion Recieved by the Working Group for Curriculum Review

Opinions
To include Point -of-care Ultrasound skills in key capabilities, e.g. Basic echocardiogram for assessing left ventricular function (M mode), appreciating poor contractility, diagnosing pneumothorax, ultrasound guided blood vessel catheter insertion. (Dr Lawrence Chan, 27 Jan 2022)
  • Working Group Replies (16 Feb 2022): Thanks, Lawrence! The Group agrees that ultrasound usage is becoming an essential skill for paediatricians. In the backbone of a curriculum statement, we think it is appropriate to state a generic requirement of POCUS but without specifying the region and the usage. We think the specific skills e.g. detecting pericardial effusion can be listed in the syllabus of the relevant subspecialty. A trainee may acquire these skills according to their scope of training.
To change the following key capabilities to a new "Optional" category and to be listed in the illustration section (Dr Eric Lee, Dr Sabrina Tsao, Dr NC Fong and Dr SP Wu, 5 March 2022):​
  • Basic Training - Peripheral arterial catheterization (reason: it is considered a skill that is nice to have, but not absolutely mandatory for all paediatricians.)​
  • Higher training - Exchange transfusion. (reason: this procedure is increasingly rare)

To accept simulation training as an alternative to real patient training in the following key capabilities (Dr Eric Lee, Dr Sabrina Tsao, Dr NC Fong and Dr SP Wu, 5 March 2022):

  • Basic Training - Advanced airway management, including tracheal intubation​
  • Basic Training - Intraosseous need insertion
  • Basic Training - Use of epinephrine auto-injector
  • Basic Training - Chest drain and chest tube insertion, including needle thoracocentesis
  • Basic Training - Use of Automated External Defibrillators

To specify performing blood culture instead of "Microbiological specimen collection" to be more specific (Dr Eric Lee, Dr Sabrina Tsao, Dr NC Fong and Dr SP Wu, 5 March 2022)

Inclusion of reduction of pulled elbow and removal of foreign body from oropharynx with Magill forceps under Domain 3 (Dr Philip Sham)

Upon the drafting of syllabus, the Working Group agreed that red reflex examination is a mandatory skill during basic training. This applies to the newborns and young children for the detection of cataract and intraocular mass. (WGCR 29 Sept 2022)

Adding the word "holistic" in the Learning outcome of Domain 1 to emphasize the importance of whole person care (WGCR 29 November 2022)

Adding 'Physical and mental health" in key capability of Domain 4 to emphasize that emergency and serious conditions does not only refer to physical body, but also the mind (WGCR 29 November 2022)

Refine the scope of advocacy in the domains. Focus on injury prevention. The difference between "Illness Prevention" and "Disease Prevention"of domain 5 (Dr CB Chow, 7 March 2023)

Responses
 Reply from Dr SP Wu (7 March 2023)​
(1) The eleven domains are the same as the ones of the Progress Curriculum of RCPCH. The wordings originated from the GMC. We tried to map the domains to the "HK Doctors" document issued by the MCHK. In the latter document, the wording was "disease prevention" and not "illness prevention". The meaning of the word was taken loosely and we do not intend for a stringent literal distinction between illness and disease. I suppose illness is broader in a sense, although this is only my take on the word.
(2) I agree that injury prevention was only tangentially alluded to in the Safeguarding domain. I will bring this to the attention of the Working Group.
(3) "Taking the interest and welfare of children as the first and most important consideration" is a learning outcome in Professional values and behavior, although the word "advocacy" appears only in the syllabuses of "Adolescent Health" and "Community Paediatrics". I will discuss with the Working group if the advocacy should be included as a learning outcome.

 

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