Domain 6
Leadership & Team Working
HK Doctors Core Competences mapped to this domain:
Roles of doctors within the healthcare system - Medical graduates should understand the healthcare system in Hong Kong and the clinical responsibilities and role of a doctor in the society. They should also appreciate the roles of doctors as researchers, mentors, teachers and managers in the system.
Team work - Team work is important in the delivery of healthcare to patients, and doctors should be able to take a leading role in a multi-professional team and appreciate the roles of other healthcare workers.
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Basic Training
Learning Outcomes
Participate effectively and constructively in multidisciplinary and inter-professional teams.
Key Capabilities
- Understand the importance of leadership and team work in common clinical settings.
- Work constructively within a team and value the contribution of team members in various disciplines and sectors.
Illustrations
- Participate regularly in multidisciplinary team case conference, joint clinics etc and work effectively with other team members.
- Contribute to multidisciplinary teams and meetings in a proactive manner and delivers all work on time.
- Take part in audit meeting and other quality improvement projects initiated by the clinical department / team.
- Guide interns, nurses and junior colleagues to work collaboratively on a daily basis.
Higher Training
Learning Outcomes
Demonstrate effective leadership qualities and critical decision-making skills.
Key Capabilities
- Coordinate and communicate effectively in a MDT to handle a range of situations with CYP and families in chronic disease settings and challenging circumstances.
- Demonstrate leadership quality and decision making ability in conflicts and critical circumstances.
Illustrations
- Actively participate in team meetings, working groups and interdepartmental projects as an independent team member.
- Be an effective coordinator or chairperson of case conferences, working groups and audit meetings.
- Give constructive feedback for the professional development of others
- Takes lead in resuscitation or in drills.
- Promotes teamwork by empowering other team members through effective delegation and communication.
- Initiate and complete projects on guidelines writing or quality improvement.
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.