Learning Objectives

MEDICAL EXPERT:

By the end of the clerkship, the student should be able to:

CLO MED54601: Provide comprehensive, targeted medical histories which will cover the following domains: [PLO 1.1]

• History of present illness

• Past medical history

• Family history

• Medication list and allergies 

• Social history 

• Substance use history

This will be achieved by:

• Interviewing the patient 

• Obtaining collateral information from family members and other physicians 

• Reviewing the health records chart

• The student should be able to provide focused oral and written summaries which demonstrate diagnostic clinical reasoning . 

CLO MED54602: Perform a complete physical examination including but not limited to: [PLO 1.1]

• Respiratory: Percussion and auscultation 

• Cardiovascular: JVP, palpation and auscultation of precordium, peripheral arterial pulses 

• Gastrointestinal: Hepatomegaly, ascites 

• Endocrine: Thyroid and diabetic foot exam 

• Musculoskeletal: Knee, hand and back examination and shoulder 

• Neurologic: Cranial nerves, Parkinson’s disease, sensory and upper and lower motor neuron lesions 

• Hematologic: Adenopathy and splenic enlargement 

CLO MED54603: Interpret relevant investigations including, but not limited to [PLO 1.3]:

•  Chest X-rays

•  ECGs

•  Urinalysis

•  CSF interpretation

•  Pleural fluid interpretation

•  Arterial blood gas interpretation

• PFT interpretation

CLO MED54604: Generate pertinent problem lists which: [PLO 1.2 and PLO 1.5]

• Cover most likely differential diagnoses 

• Consider rare but serious diagnoses

• Include etiologies and plans for management 

CLO MED54605: Synthesize relevant information and apply it to clinical decision making taking into account the patient and family context. [PLO 1.4]

CLO MED54606: Develop a systematic approach to assessment, diagnosis and management to patients presenting with the following issues: [PLO 1.1, PLO 1.2, PLO 1.3, PLO 1.4 and PLO 1.5]

• Shock 

• Chest pain

• Altered level of consciousness 

• Dyspnea 

• Upper GI Bleed 

• Lower GI bleed

• Acute renal failure, electrolyte disorders and calcium disorders 

• Fever 

• Substance intoxication and withdrawal

• Pain and symptom control in the inpatient setting

• Respiratory failure 

CLO MED54607: Develop a systematic approach to the key diagnostic features (including history, physical and investigations)and management of common or high impact medical syndromes: [PLO 1.1, PLO 1.2, PLO 1.3, PLO 1.4 and PLO 1.5]

CLO MED54608: Demonstrate appropriate use of electronic medical records to support patient care including clinical decision making, documentation, and communication. [PLO 1.7]

COMMUNICATOR:

• CLO C211: Gather information about a patient’s beliefs, concerns, expectations and illness experience in a patient centered manner. [PLO 2.1]

• CLO C212: Demonstrate effective use of verbal and non-verbal communication skills to build a relationship with the patient (e.g. using open-ended inquiry, listening attentively and verifying for mutual understanding). [PLO 2.1]

• CLO C213: Demonstrate attention to  human diversity, including differences in age, sex, gender identity, disability, sexual orientation, ethnicity, cultural background, religious beliefs,  socioeconomic, or psychosocial factors. [PLO 2.1]

• CLO C214: Demonstrate a respectful and empathetic patient-physician relationship. [PLO 2.1]

• CLO C215: Explain the principles of dealing with challenging communication issues. [PLO 2.1]

• CLO C221: Demonstrate obtaining appropriate informed consent prior to taking a history or performing a physical exam. [PLO 2.2]

• CLO C222: Demonstrate a culturally safe and trauma-informed approach to history taking and physical examination of a patient by using language and maneuvers to communicate respect, build a sense of safety, autonomy and trust. [PLO 2.2]

• CLO C223: Identify situations that may result in strong emotional reactions. [PLO 2.2]

• CLO C231: Deliver information using clear and appropriate language and checks for patient understanding. [PLO 2.3]

• CLO C232: Discuss informed consent with a patient. [PLO 2.3]

• CLO C233: Engage patients and their families in developing plans that reflect the patient's health care needs, values, and goals. [PLO 2.3]

• CLO C241: Synthesize a patient's history, examination findings and/or relevant investigations in a clear and concise manner, while highlighting key features. [PLO 2.4]

• CLO C242: Complete all required documentation, such as notes, assessments,  and discharge summaries in an accurate, legible and timely manner. [PLO 2.4]

COLLABORATOR:

• CLO C311: Work collaboratively with peers, caregivers, and interdisciplinary team members. [PLO 3.1]

• CLO C312: Discuss the role and responsibilities of other healthcare professionals. [PLO 3.1]

• CLO C313: Refer patients to community resources, as applicable, to support health maintenance and wellness. [PLO 3.1]

• CLO C314: Collaborate with members of the interdisciplinary healthcare team to provide coordinated care for patients. [PLO 3.1]

• CLO C315: Provide effective and safe handover or transfer of care. [PLO 3.1]

• CLO C321: Contribute to a healthy working environment by recognizing personal differences, biases, assumptions and limitations. [PLO 3.2]

• CLO C322: Interact respectfully and professionally with team members. [PLO 3.2]

• CLO C323: Demonstrate conflict resolution strategies that can be used in a learning and/or clinical setting. [PLO 3.2]

• CLO C331: Identify individual responsibilities, strengths, and limitations using feedback for improvement. [PLO 3.3]

• CLO C332: Provide specific and actionable feedback in a professional and respectful manner. [PLO 3.3]

LEADER:

• CLO C411: Discuss the role of physicians in the healthcare system and how it varies between different settings (e.g. ER, Hospital, Community Care). [PLO 4.1]

• CLO C421: Identify opportunities for quality improvement in healthcare settings. [PLO 4.2]

• CLO C422: Discuss steps of quality improvement in healthcare settings. [PLO 4.2]

• CLO C431: Discuss the concept of resource allocation and the role of the physician as a steward of resources in the management of an individual patient’s health care and in the context of the healthcare system as a whole. [PLO 4.3]

• CLO C432: Incorporate cost perspectives in clinical decision-making. [PLO 4.3] 

HEALTH ADVOCATE:

• CLO C511: Recognize different points of view regarding culture, religion, beliefs, illness, disease, and medical practices and discuss in an open and non-judgmental manner. [PLO 5.1]

• CLO C512: Describe how different social determinants of health influence illness, disease and disability; and how they affect access to health care services. [PLO 5.1]

• CLO C513: Respond to a patient's health needs by advocating with the patient within the clinical environment. [PLO 5.1]

• CLO C521: Identify emerging and ongoing health issues for vulnerable populations. [PLO 5.2]

• CLO C522: Explain the concept of social accountability and principles of community engagement in responding to the needs of the community. [PLO 5.2]

• CLO C523: Identify points of influence in the healthcare system as potential targets for advocacy. [PLO 5.2]

• CLO C531: Demonstrate advocacy with regards to helping patients navigate the healthcare system. [PLO 5.3]

• CLO C532: Contribute to an inclusive patient care environment for marginalized populations. [PLO 5.3]

• CLO C541: Participate in patient safety measures in a clinical context. [PLO 5.4]

• CLO C551: Discuss opportunities for promoting health and preventing disease in patient encounters. [PLO 5.5]

• CLO C552: Demonstrate principles of risk stratification in patient encounters. [PLO 5.5]

SCHOLAR:

• CLO C611: Formulate a clinical question and search the literature utilizing appropriate tools and resources. [PLO 6.1]

• CLO C612: Critically appraise evidence and information in order to inform diagnostic clinical reasoning and decision making. [PLO 6.1]

• CLO C621: Apply the concepts of critical appraisal to answer clinical questions. [PLO 6.2]

• CLO C622: Discuss appropriate healthcare screening recommendations applicable to a patient. [PLO 6.2]

• CLO C623: Discuss opportunities for risk reduction and disease prevention in a patient context. [PLO 6.2]

• CLO C624: Integrate best available evidence into practice considering context, epidemiology of disease, and comorbidity of patients. [PLO 6.2]

• CLO C631: Identify personal learning objectives and design strategies to meet them. [PLO 6.3]

• CLO C632: Demonstrate ability to engage in self-directed learning based on reflective practice and life-long learning principles. [PLO 6.3]

• CLO C633: Demonstrate insight into personal limitations and identify areas for personal development. [PLO 6.3]

PROFESSIONAL:

• CLO C711: Demonstrate the key values of professionalism, including honesty, respect,  integrity, confidentiality, boundary setting, altruism and promotion of the public good. [PLO 7.1]

• CLO C712: Discuss that self-regulation of the profession is a privilege, including the obligation to actively maintain professional competence, and participation in peer/colleague assessment and self-assessment. [PLO 7.1]

• CLO C713: Treat patients with respect while maintaining patient confidentiality and autonomy. [PLO 7.1]

• CLO C714: Explain how self-reflection facilitates professional identity formation. [PLO 7.1]

• CLO C721: Describe the supports and resources that enable learners and physicians to maintain a healthy work-life integration and resilience. [PLO 7.2]

• CLO C722: Balance personal and professional responsibilities to ensure personal health, academic achievement, and the highest quality of patient care. [PLO 7.2]

• CLO C731: Discuss basic legal and ethical challenges that physicians face in practice. [PLO 7.3]

• CLO C732: Describe the principles and limits of patient confidentiality. [PLO 7.3]