medportal CDB | Taxonomy | Level Of Competence / Knows How - Clerkship

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Level Of Competence

Knows How - Clerkship

Objectives (204)

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Objectives

Describe how you would assess a patient's volume status
Clerkship Objectives

Clerkship / Anesthesia Rotation

Explain the concept of balanced anesthesia and its role in modern general anesthetics
Clerkship Objectives

Clerkship / Anesthesia Rotation

Explain the presentation and management of malignant hyperthermia as an example of the hypermetabolic state
Clerkship Objectives

Clerkship / Anesthesia Rotation

Explain the goals and phases of general anesthesia
Clerkship Objectives

Clerkship / Anesthesia Rotation

Explain the following concepts as they relate to drugs administered via intravenous: half-life, therapeutic range, metabolism, redistribution, elimination and target organ
Clerkship Objectives

Clerkship / Anesthesia Rotation

Identify intravenous drugs used in the induction, maintenance and emergence of general anesthesia, including indications for use, mechanism of action, and common side effects
Clerkship Objectives

Clerkship / Anesthesia Rotation

Identify inhalation anesthetic agents used in the induction and maintenance of general anesthesia including mode of delivery, indications of use, mechanism of action, concept of minimum alveolar concentration and common side effects
Clerkship Objectives

Clerkship / Anesthesia Rotation

Explain the presentation and management of pseudocholinesterase (plasma cholinesterase) deficiency as an example of a pharmacogenetic disease.
Clerkship Objectives

Clerkship / Anesthesia Rotation

List indications for endotracheal intubation, use of LMA, and indications for mechanical ventilation
Clerkship Objectives

Clerkship / Anesthesia Rotation

Describe criteria for extubation
Clerkship Objectives

Clerkship / Anesthesia Rotation

List the types of patients who are at highest risk of aspiration. Explain how we prevent aspiration and describe how aspiration is treated.
Clerkship Objectives

Clerkship / Anesthesia Rotation

Describe at least 3 systems for delivering oxygen to patients
Clerkship Objectives

Clerkship / Anesthesia Rotation

Describe how we measure patient ventilation and oxygenation and how to determine if they are adequate.
Clerkship Objectives

Clerkship / Anesthesia Rotation

List the causes of hypoxemia. Describe appropriate treatment of hypoxemia in the perioperative setting.
Clerkship Objectives

Clerkship / Anesthesia Rotation

Explain common mechanical ventilation parameters (volume control and pressure control ventilation, respiratory rate, tidal volume, pressure and PEEP)
Clerkship Objectives

Clerkship / Anesthesia Rotation

Explain how euvolemia can be disturbed/altered in the perioperative period and how these alterations are managed.
Clerkship Objectives

Clerkship / Anesthesia Rotation

Define shock and explain how shock can be classified (types and degree). Describe potential treatments for the patient in shock, including the rational use of vasoactive and inotropic medications.
Clerkship Objectives

Clerkship / Anesthesia Rotation

Describe appropriate uses for the following crystalloid solutions: normal saline, Ringer's lactate, D5W, D5W/NS. Describe appropriate uses of the colloid solutions albumin and Pentaspan. Explain the complications of using these fluids.
Clerkship Objectives

Clerkship / Anesthesia Rotation

Substance abuse
Clerkship Objectives

Clerkship / Family Medicine Rotation

Domestic abuse / family violence
Clerkship Objectives

Clerkship / Family Medicine Rotation

Sexual health counseling
Clerkship Objectives

Clerkship / Family Medicine Rotation

Asthma
Clerkship Objectives

Clerkship / Family Medicine Rotation

Cryotherapy, i.e. of warts or other suitably treated benign skin lesion
Clerkship Objectives

Clerkship / Family Medicine Rotation

Pelvic exam
Clerkship Objectives

Clerkship / Family Medicine Rotation

Ear syringing
Clerkship Objectives

Clerkship / Family Medicine Rotation

An understanding of how virtual or same-site interprofessional teams function in the context of the primary care environment.
Clerkship Objectives

Clerkship / Family Medicine Rotation

Appreciate the challenges in addressing complex, diverse patient care issues longitudinally.
Clerkship Objectives

Clerkship / Family Medicine Rotation

Appreciate the nature of some of the specific challenges in the provision of primary care to patients, such as addressing undifferentiated illness, chronic illnesses and preventive care issues.
Clerkship Objectives

Clerkship / Family Medicine Rotation

Gain skills and experience in meeting patients’ needs for prevention, problem identification and management, and complex disease management through episodic care of patients and their families in the community practice setting.
Clerkship Objectives

Clerkship / Family Medicine Rotation

Understand the special needs of vulnerable groups related to disparities and inequities in seeking and receiving care. (e.g. Aboriginals, recent immigrants, same-sex relationships, transgendered, marginally housed, disabled, age extremes).
Clerkship Objectives

Clerkship / Family Medicine Rotation

Understand how to complete a death certificate.
Clerkship Objectives

Clerkship / Internal Medicine Rotation

Write prescriptions accurately (under supervision).
Clerkship Objectives

Clerkship / Internal Medicine Rotation

Demonstrate awareness of hospital policies affecting patient care (e.g., use of restraints, infection control practices).
Clerkship Objectives

Clerkship / Internal Medicine Rotation

Demonstrate awareness of regulations concerning psychiatric confinement of medical patients.
Clerkship Objectives

Clerkship / Internal Medicine Rotation

Arterial blood gas
Clerkship Objectives

Internal Medicine Rotation

EKG
Clerkship Objectives

Internal Medicine Rotation

Thoracentesis
Clerkship Objectives

Internal Medicine Rotation

Abdominal paracentesis
Clerkship Objectives

Internal Medicine Rotation

Lumbar puncture
Clerkship Objectives

Internal Medicine Rotation

NG (Nasogastric) insertion
Clerkship Objectives

Internal Medicine Rotation

Palpitations
Clerkship Objectives

Clerkship / Medical Foundation 1 / Medical Foundation 2 / Emergency Medicine Rotation / Family Medicine Rotation / Internal Medicine Rotation

Syncope
Clerkship Objectives

Clerkship / Medical Foundation 1 / Medical Foundation 2 / Emergency Medicine Rotation / Family Medicine Rotation / Internal Medicine Rotation

Falls
Clerkship Objectives

Clerkship / Emergency Medicine Rotation / Family Medicine Rotation / Internal Medicine Rotation

Describe modalities of analgesia used in labour and delivery
Clerkship Objectives

Clerkship / Anesthesia Rotation / Obstetrics and Gynecology Rotation

Management of normal delivery
Framework Objectives

Obstetrics and Gynecology Rotation

Approach to management for preeclampsia-eclampsia syndrome
Framework Objectives

Obstetrics and Gynecology Rotation

Describe the approach to patient with third-trimester bleeding
Framework Objectives

Obstetrics and Gynecology Rotation

Compare symptoms, physical findings, diagnostic methods, that differentiate patients with placenta previa, abruption placenta, and other causes of 3rd trimester bleeding
Framework Objectives

Obstetrics and Gynecology Rotation

Describe complications of placenta previa and abruption placenta.
Framework Objectives

Obstetrics and Gynecology Rotation

Describe immediate management of shock secondary to 3rd trimester bleeding
Framework Objectives

Obstetrics and Gynecology Rotation

Describe the management of prolonged gestation
Framework Objectives

Obstetrics and Gynecology Rotation

Ethical issues raised concerning abortion
Framework Objectives

Obstetrics and Gynecology Rotation

Normal vaginal appearance and secretions
Framework Objectives

Obstetrics and Gynecology Rotation

Evaluation and management of common vulvar and vaginal problems including:
Framework Objectives

Obstetrics and Gynecology Rotation

Vaginitis due to bacteria, fungi, trichomonads, viruses, foreign bodies or atrophy
Framework Objectives

Obstetrics and Gynecology Rotation

Dermatologic conditions of vulva
Framework Objectives

Obstetrics and Gynecology Rotation

Bartholin's gland disease
Framework Objectives

Obstetrics and Gynecology Rotation

Vulvodynia
Framework Objectives

Obstetrics and Gynecology Rotation

Trauma (Vulvar and Vaginal)
Framework Objectives

Obstetrics and Gynecology Rotation

Distinguish abnormal uterine bleeding from dysfunctional uterine bleeding
Framework Objectives

Obstetrics and Gynecology Rotation

Evaluate and diagnose abnormal uterine bleeding
Framework Objectives

Obstetrics and Gynecology Rotation

Describe therapeutic options for abnormal uterine bleeding.
Framework Objectives

Obstetrics and Gynecology Rotation

Management strategies for dysmenorrhea
Framework Objectives

Obstetrics and Gynecology Rotation

Management of climacteric including:
Framework Objectives

Obstetrics and Gynecology Rotation

Hormone therapy (HRT) (Management of climacteric)
Framework Objectives

Obstetrics and Gynecology Rotation

Nutrition and exercise (Management of climacteric)
Framework Objectives

Obstetrics and Gynecology Rotation

Non-hormonal therapeutic options during climacteric
Framework Objectives

Obstetrics and Gynecology Rotation

Describe the risks and benefits of HRT
Framework Objectives

Obstetrics and Gynecology Rotation

Evaluation and management of infertility
Framework Objectives

Obstetrics and Gynecology Rotation

Evaluation and management of the patient with the abnormal pap smear
Framework Objectives

Obstetrics and Gynecology Rotation

Cite prevalence and incidence of violence against women, elder abuse, and child abuse
Framework Objectives

Obstetrics and Gynecology Rotation

Assess the involvement of any patient in domestic violence situations
Framework Objectives

Obstetrics and Gynecology Rotation

Council patients for short term safety (in domestic violence situations).
Framework Objectives

Obstetrics and Gynecology Rotation

Council patients regarding local support agencies for long term management and resources (in domestic violence situations).
Framework Objectives

Obstetrics and Gynecology Rotation

Council patients requiring resources for batterers and perpetrators of domestic violence
Framework Objectives

Obstetrics and Gynecology Rotation

Ethics in Obstetrics and Gynecology
Framework Objectives

Clerkship / Medical Foundation 3 / Obstetrics and Gynecology Rotation

Hematuria
Clerkship Objectives

Medical Foundation 3 / Emergency Medicine Rotation / Family Medicine Rotation / Obstetrics and Gynecology Rotation

Vaginal discharge/urethral discharge
Clerkship Objectives

Medical Foundation 3 / Emergency Medicine Rotation / Family Medicine Rotation / Obstetrics and Gynecology Rotation

Menstrual irregularities, excessive vaginal bleeding and dysmenorrhea
Clerkship Objectives

Medical Foundation 3 / Emergency Medicine Rotation / Family Medicine Rotation / Obstetrics and Gynecology Rotation

Breast abnormality
Clerkship Objectives

Medical Foundation 3 / Emergency Medicine Rotation / Family Medicine Rotation / Obstetrics and Gynecology Rotation

Management of early pregnancy loss
Clerkship Objectives

Medical Foundation 3 / Emergency Medicine Rotation / Family Medicine Rotation / Obstetrics and Gynecology Rotation

Pap test
Clerkship Objectives

Clerkship / Family Medicine Rotation / Obstetrics and Gynecology Rotation

Sexually transmitted infections sampling.
Clerkship Objectives

Clerkship / Family Medicine Rotation / Obstetrics and Gynecology Rotation

Describe aspects of the maternal prenatal history and labor and delivery course that have implications for the health of the newborn.
Clerkship Objectives

Pediatrics Rotation

Assess major developmental milestones (gross motor, fine motor, social, language)
Clerkship Objectives

Pediatrics Rotation

Assess the sexual maturity of male and female adolescents using the Tanner method.
Clerkship Objectives

Pediatrics Rotation

Identify growth that deviates from expected patterns based on the family growth history and the child’s previous growth
Clerkship Objectives

Pediatrics Rotation

Recognize an acutely ill child who requires immediate medical attention.
Clerkship Objectives

Pediatrics Rotation

Describe an approach to the Dysmorphic child
Clerkship Objectives

Pediatrics Rotation

Describe unique features of the physician-patient relationship during adolescence, including confidentiality and consent
Clerkship Objectives

Pediatrics Rotation

Describe the unique contributions of each member of a multidisciplinary team in caring for children with chronic illness
Clerkship Objectives

Pediatrics Rotation

Describe strategies for health maintenance during well child visits from birth to adolescence
Clerkship Objectives

Pediatrics Rotation

Recognize social determinants of the health of Canadian children.
Clerkship Objectives

Pediatrics Rotation

Understand Canadian laws for mandatory reporting of suspected child abuse and procedures for reporting
Clerkship Objectives

Pediatrics Rotation

Recognize, describe the differential diagnosis and understand methods to manage common pediatric conditions including:
Clerkship Objectives

Pediatrics Rotation

Identify factors that determine whether each problem should be managed in the inpatient or outpatient setting.
Clerkship Objectives

Pediatrics Rotation

Describe the ABCD assessment of an acutely ill child
Clerkship Objectives

Pediatrics Rotation

Outline the initial steps in the assessment and stabilization of the child with critical and acute pediatric illness including:
Clerkship Objectives

Pediatrics Rotation

Describe the clinical features, complications and common management strategies of childhood chronic illnesses including:
Clerkship Objectives

Pediatrics Rotation

Develop an initial approach to the assessment of the child with school difficulties.
Clerkship Objectives

Pediatrics Rotation

Pelvic pain - acute
Clerkship Objectives

Medical Foundation 2 / Emergency Medicine Rotation / Family Medicine Rotation / Internal Medicine Rotation / Obstetrics and Gynecology Rotation / Surgery Rotation

Weight loss
Clerkship Objectives

Medical Foundation 2 / Emergency Medicine Rotation / Family Medicine Rotation / Internal Medicine Rotation / Obstetrics and Gynecology Rotation / Surgery Rotation

Injections: subcutaneous, intradermal, intramuscular and intravenous
Clerkship Objectives

Clerkship / Family Medicine Rotation / Surgery Rotation

Demonstrate an approach to the diagnosis and management of undifferentiated patient problems that present to family physicians.
Clerkship Objectives

Family Medicine TTR / Clerkship / Family Medicine Rotation

Demonstrate an approach to the diagnosis and management of common patient problems that present to family physicians (see Essential Clinical Encounter presenting problems for Family Medicine).
Clerkship Objectives

Family Medicine TTR / Clerkship / Family Medicine Rotation

Demonstrate effective communication skills in conducting a patient centered interview, including exploring the patient’s illness experience as well as the family and social context.
Clerkship Objectives

Family Medicine TTR / Clerkship / Family Medicine Rotation

Demonstrate an approach to health promotion and disease prevention during patient encounters that reflect best evidence and patient preferences and values.
Clerkship Objectives

Family Medicine TTR / Clerkship / Family Medicine Rotation

Conduct a sensitive, focused physical exam relevant to the patient’s presenting problem.
Clerkship Objectives

Family Medicine TTR / Clerkship / Family Medicine Rotation

Demonstrate effective oral and written communication skills in documenting clinical encounters, making oral case presentations, prescription writing and making referrals to other care providers through clear, concise, efficient communication strategies.
Clerkship Objectives

Family Medicine TTR / Clerkship / Family Medicine Rotation

Demonstrate life long learning practices in providing care to patients.
Clerkship Objectives

Family Medicine TTR / Clerkship / Family Medicine Rotation

Discuss evidence-based approaches to patient care and the challenges of applying guidelines to individual patients.
Clerkship Objectives

Family Medicine TTR / Clerkship / Family Medicine Rotation

Identify and/or communicate with other health care providers and community programs to support and/or optimize patient care.
Clerkship Objectives

Family Medicine TTR / Clerkship / Family Medicine Rotation

Discuss common ethical issues in family medicine through the life cycle including topics such as confidentiality, consent and capacity.
Clerkship Objectives

Family Medicine TTR / Clerkship / Family Medicine Rotation

Order appropriate imaging investigations
Clerkship Objectives

Surgery TTR / Transition to Clerkship / Clerkship / Surgery Rotation

Interpret imaging investigations
Clerkship Objectives

Surgery TTR / Clerkship / Surgery Rotation / Transition to Residency

Identify, reflect on, and discuss with peers a “Procomp Moment” during your surgical clerkship that involved communication, consent, adverse event, professional behavior, personal health, or medical student role in the hierarchy.
Clerkship Objectives

Surgery TTR / Clerkship / Surgery Rotation / Transition to Residency

Recto-vaginal Examination
Framework Objectives

The learner will be able to describe how common illnesses present differently in the family practice environment than in the specialist setting:
Framework Objectives

Prevalence of diagnoses/illnesses in the community.
Framework Objectives

Ill-defined nature of early presentations.
Framework Objectives

Greater uncertainty because patients present at an early, undifferentiated stage of their illnesses — in up to 50% of visits, definitive diagnosis is not possible.
Framework Objectives

Time as a diagnostic tool.
Framework Objectives

Appropriate follow-up management.
Framework Objectives

Appropriate use of diagnostic tools. Because disease prevalence is usually lower in a family practice setting than in a specialty service, the predictive value of many investigations is poor; tests that are useful in a specialty discipline are of little or no value in a family practice.
Framework Objectives

Appropriate use of consultation with other health care providers.
Framework Objectives

Recognition of variants of normal that are not classified as illness.
Framework Objectives

The learner will be able to carry out a patient-centred interview that will include the following:
Framework Objectives

Recognition of the difference between illness and disease and application of this distinction in assessment and management of patient problems.
Framework Objectives

Routine exploration of patients’ experiences of illness—their feelings, their ideas, effects of the illness on function, and expectations for care. (The acronym FIFE is often used as an aide-mémoire for these issues.)
Framework Objectives

Exploration of patients’ personal history and context (family, job, school, geography, environment, etc.).
Framework Objectives

Shared decision-making/finding common ground—supporting patients to have as active a role in all decisions affecting their health care as they desire.
Framework Objectives

Patient education.
Framework Objectives

Recognition of a range of approaches to collaborating with patients, and of when each approach (deliberative, interpretive, informative, and paternalistic) is most appropriate.
Framework Objectives

The learner will demonstrate effective communication skills in data gathering. The learner will be able to do the following:
Framework Objectives

Use appropriate open-ended questions.
Framework Objectives

Use appropriate closed-ended questions.
Framework Objectives

Demonstrate active listening.
Framework Objectives

Paraphrase.
Framework Objectives

Use non-verbal indicators of engagement with the patient.
Framework Objectives

Use appropriate time management.
Framework Objectives

The learner will demonstrate sensitivity when asking intimate questions of patients. The following are examples of intimate issues: Drug use, alcohol use, sexual practices, abuse history.
Framework Objectives

The learner will be able to take a history that includes the non-biological determinants of health. These include the following: housing, socioeconomic status, social network, education, work, culture, environment.
Framework Objectives

The learner will use appropriate record keeping when caring for patients. For example:
Framework Objectives

The learner will construct structured notes (e.g., subjective, objective, assessment, plan [SOAP] structure).
Framework Objectives

The learner will construct well-organised and comprehensive problem lists.
Framework Objectives

The learner will construct well-organised summaries/consultations to another health care provider.
Framework Objectives

The learner will understand the issues around consent to treatment and substitute decision making:
Framework Objectives

Informing patients about options for management and consequences of each choice.
Framework Objectives

Advance directives.
Framework Objectives

Power of attorney.
Framework Objectives

Competency assessment.
Framework Objectives

Working with substitute decision makers.
Framework Objectives

The learner will show a basic and appropriate level of understanding of a pharmacotherapeutic approach to treating primary care conditions, considering, at an appropriate level, pharmacodynamics, pharmacokinetics, side effects, important drug interactions, dosages, and costs.
Framework Objectives

The learner will demonstrate comfort in the use of non-pharmacologic modalities:
Framework Objectives

The physician-patient relationship.
Framework Objectives

Supportive therapy.
Framework Objectives

Specific approaches (e.g., cognitive-behavioural therapy, family approaches, other modalities).
Framework Objectives

Motivational interviewing (based on “stages of change” theory).
Framework Objectives

Lifestyle counselling (e.g., on nutrition, exercise).
Framework Objectives

The learner will demonstrate a general approach to palliative care issues:
Framework Objectives

Pain assessment.
Framework Objectives

Pain control.
Framework Objectives

Pain equivalency.
Framework Objectives

End-of-life issues.
Framework Objectives

Control of other symptoms (e.g., shortness of breath, anxiety, nausea and vomiting, anorexia, cough, diarrhoea, constipation, hiccups).
Framework Objectives

Providing comfort and support (to patients and families).
Framework Objectives

Supporting caregivers.
Framework Objectives

Assessing and providing support for spiritual issues.
Framework Objectives

The learner will recognise that the patient-physician relationship is central to the practice of family medicine:
Framework Objectives

Communication with patients, family, communities, and colleagues (see skilled clinician).
Framework Objectives

Respect for differences in beliefs and backgrounds.
Framework Objectives

Establishment of professional relationships with patients, families, communities, and colleagues.
Framework Objectives

The learner will appreciate the value of continuity of care for developing a deep knowledge of patients:
Framework Objectives

Ongoing patient care visits over time for chronic and episodic care.
Framework Objectives

Home visits.
Framework Objectives

Nursing home visits.
Framework Objectives

Chronic care.
Framework Objectives

The learner will reflect on his or her development as a physician:
Framework Objectives

Respect for self/self care, with recognition of the importance of personal health on one’s ability to care for others.
Framework Objectives

Appreciation of personal development/self reflection.
Framework Objectives

The learner will be able to identify what health-promotion and disease-prevention activities are appropriate to particular populations, using the Canadian Task Force A and B recommendations. (The learner should know the A and B recommendations with a high burden of illness and the important/controversial C and I recommendations. See the Canadian Task Force Web site for the listing http://www.ctfphc.org/.)
Framework Objectives

The learner will be able to demonstrate how to introduce health-promotion and disease-prevention activities into the clinical encounter:
Framework Objectives

Awareness of stages of change theory.
Framework Objectives

Awareness of systems for health-promotion and prevention activities in the office.
Framework Objectives

The learner will be able to describe some of the methodological and ethical issues related to screening healthy and at-risk populations:
Framework Objectives

Ethical issues including, for example, cost, benefit versus harm, opportunity cost, burden on the health care system).
Framework Objectives

Methodological issues (e.g., sensitivity, specificity, biases).
Framework Objectives

Potential conflicts between practice guidelines and patient autonomy and preference.
Framework Objectives

The learner will be able to demonstrate evidence-based decision making to aid patients and him- or herself with clinical decisions:
Framework Objectives

Identification of evidence-based resources.
Framework Objectives

Demonstrated ability to appraise a variety of resources critically.
Framework Objectives

Synthesis of relevant resources/information to help make a clinical decision.
Framework Objectives

Integration of evidence with clinical expertise and patient values.
Framework Objectives

The learner will understand the team approach in the care of ambulatory patients: (Note: The team is a group of individuals who work toward the resolution of a patient problem.)
Framework Objectives

Benefits of an interdisciplinary approach.
Framework Objectives

Challenges of an interdisciplinary approach.
Framework Objectives

Contributions of all health care team members.
Framework Objectives

Working with other health care providers within the team.
Framework Objectives

Seeking and applying appropriate resources within the hospital, the patient’s family, and the community to aid treatment and rehabilitation.
Framework Objectives

The learner will demonstrate the ability to liaise with appropriate community resources in the care of a patient:
Framework Objectives

Securing appropriate community resources available to aid a patient.
Framework Objectives

Transferral of care (hospital, community, long-term-care with a community organisation).
Framework Objectives

Sharing of care (hospital, community, long-term-care with a community organisation).
Framework Objectives

The learner will be able to formulate a written or verbal referral plan and to justify this plan with respect to the following characteristics: Clarity. Appropriateness. Succinctness.
Framework Objectives

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