Learning Outcomes

Programme Learning Outcomes

 set out in the 6 domains of ACGM-I, the definition of which follows each heading

 

  1. Professionalism.

  2. Patient Care and Procedural Skills

  3. Medical Knowledge

  4. Practice-based Learning and Improvement

  5. Interpersonal and Communication Skills

  6. Systems-based Practice

Here you see the Programme Level Learning outcomes mapped to those domains, expressed as behavioural descriptors of the graduate

1.Professionalism

Graduates must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles

  • Behaves at all times in accordance with their legal and ethical responsibilities

  • Understands the theory and practice of managing ethical dilemmas in clinical situations

  • Provides compassionate treatment of patients, respecting their privacy and dignity

  • Demonstrates understanding of patient capacity, consent and confidentiality in delivering medical care

  • Identifies and safeguards vulnerable patients

  • Demonstrates honesty, integrity, accountability and responsibility in all interactions with patients and their families, colleagues, and other health care workers

  • Advocates the interests of patients over their own, showing respect for racial, cultural, and religious differences

  • Takes prompt action on any issue of safety or quality of patient care, raising and escalating concerns where necessary

 

2.Patient Care and Procedural Skills

Graduates must provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health

  • Takes a relevant accurate history about the patient and their problems, to include physical, psychological, social and cultural elements. Interpreters or family members may be included in this history taking

  • Performs general and system-specific physical and mental health examination, identifying any abnormal or unexpected findings

  • Uses clinical judgement and critical appraisal skills to make informed, cost-effective decisions about ordering evidence based diagnostic and therapeutic interventions

  • Uses clinical reasoning to develop an appropriate differential diagnosis and identify related problems

  • Generates and initiates appropriate management plan for the patient in the context of the multidisciplinary team

  • Demonstrates awareness of the factors that predispose individuals to disease or injury

  • Demonstrates an understanding of basic human factors principles and practice at individual, team, organisational and system levels and how these may impact patient care

  • Applies understanding of preventative medicine, including patient education, to promote good health for all individuals

  • Recognizes immediately life-threatening conditions and institutes appropriate initial therapy including effective Basic Life Support

  • Demonstrates competence in a defined range of clinical skills unsupervised and to a predetermined standard

  • Deals appropriately with complexity and uncertainty including managing multimorbidity and prioritising tasks

 

3.Medical Knowledge

Graduates must demonstrate knowledge of established and evolving biomedical clinical, epidemiological, and social-behavioural sciences, as well at the application of this knowledge to patient care
 

  • Demonstrates an understanding of the normal structure and function of the individual that are important in maintaining homeostasis, and the alterations to these that result from age or pathology

  • Demonstrates an understanding of the pathophysiology, symptomology, investigation and treatment of specific diseases

  • Understands the science and interpretation of common diagnostic and therapeutic procedures

  • Understands the physical, psychological, cultural and social factors that may influence the maintenance of health, the presentation and course of illness, and the outcomes of treatment

  • Proposes individualised interventions to improve patients’ health related behaviour

  • Accommodates patient choice, empowering patients so as to increase self-help and improve concordance

  • Evaluates psychological and social factors influencing own behaviour and that of colleagues in medical settings

 

4.Practice-based Learning and Improvement

Graduates must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self- evaluation and lifelong learning

  • Understands the principles and use of evidence-based medicine, demonstrating this in the care of individuals and populations

  • Understands the principles and practice of formulating and investigating an answerable health care question as applied to a patient or population

  • Able to collect, assimilate and critically appraise information, (e.g. scientific papers, data) relevant to the care of individuals and populations

  • Understands practice-based learning and quality improvement techniques. This includes routine self-evaluation and appraisal of current best practice, with consequent improvements in patient care provision

  • Demonstrates the habit of life-long learning, making changes to own practice in response to learning opportunities

5.Interpersonal and Communication Skills

Graduates must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals

  • Demonstrates the ability to build rapport and show empathy to communicate compassionately, effectively, and in culturally and emotionally appropriate ways, with patients, their families, colleagues and others involved in the care of their patients

  • Demonstrates the ability to establish effective therapeutic relationships with patients and their families to provide reassurance, instil trust and maximise health outcomes

  • Demonstrates effective teamworking and leadership skills including reliability, punctuality collegiality, adaptability, trustworthiness and responsibility

  • Works collaboratively and effectively within multidisciplinary teams, sometimes across different settings, to provide safe and holistic health care to patients

  • Creates and maintains accurate, timely and legible medical records, and accurately presents findings to other healthcare professionals, communicating effectively in all media

  • Handles patient-identifiable information in a confidential manner

 

6.Systems-based Practice

Graduates must demonstrate an awareness of and responsiveness to the larger context and system of health care, including the social determinates of health, as well as the ability to call effectively on other resources in the system to provide optimal patient care

  • Recognises the wider determinants of health including economic, psychological, social, religious, historical, and cultural factors and how these contribute to health inequalities, both within Myanmar and globally

  • Demonstrates an understanding of the impact of health inequalities at the population and individual level, and supports the reduction of health disparity, especially as related to minority group individuals and underserved populations

  • Demonstrates an understanding of the use of epidemiological principles in assessing the health of the population and their applications to priority setting, resource allocation and service evaluation

  • Understands the principles of how to build teams and maintain effective team work to optimise patient care

  • identifies, and responds to, basic human factors principles and practice at individual, team, organisational and system levels and how these may impact patient care

  • Understands the settings, and inter-relationships of different health care settings and the importance of integrating patients’ care across them to ensure person-centred care

  • Understands health care financing, priority setting of resources and service evaluation

  • Demonstrates an understanding of the opportunities and threats to health care provision posed by potential conflicts of interest

Myanmar Curriculum Learning Outcomes 2021

 

 

Vertical Modules Learning Outcomes

 

  1. Ethics and Professionalism

  2. Clinical Management and Observation

  3. Research and Medical Education

  4. Social and Behavioural Science

  5. Community Health

  6. Family Medicine

Here you see the Module Level Learning outcomes mapped to those domains, expressed as behavioural descriptors of the graduate

i. Ethics and Professionalism:

The graduating doctor should demonstrate high ethical standards and professionalism, providing holistic patient care that is safe, appropriate, effective and compassionate. Specifically, the graduate:

  • Behaves at all times in accordance with their legal and ethical responsibilities

  • Understands the theory and practice of managing ethical dilemmas in clinical situations

  • Provides compassionate treatment of patients, respecting their privacy and dignity

  • Demonstrates understanding of patient capacity, consent and confidentiality in delivering medical care

  • Identifies and safeguards vulnerable patients

  • Demonstrates honesty, integrity, accountability and responsibility in all interactions with patients and their families, colleagues, and other health care workers

  • Advocates the interests of patients over their own, showing respect for racial, cultural, and religious differences

  • Takes prompt action on any issue of safety or quality of patient care, raising and escalating concerns where necessary

  • Uses self-evaluation to recognize and accept limitations in own knowledge and skills, seeking timely and appropriate support

  • Works effectively, respectfully and supportively as a member of the team: adapts behaviour to improve outcomes

  • Demonstrates respect for own health and the health of colleagues.  Understands the effects of personal behaviour on practice

  • Recognises where conflicts of interest may occur in the doctor-patient relationship and takes appropriate steps to ensure patient care is not impacted

ii.  Clinical management and observation:

The graduating doctor should be able to integrate the knowledge of pathophysiology, clinical and non-clinical skills they have learnt throughout the course to effectively, safely and compassionately assess and initiate management for the symptomatic presenting patient. Specifically, the graduate:

 

  • Demonstrates an understanding of the normal structure and function of the individual that are important in maintaining homeostasis, and the alterations to these that result from age or pathology

  • Demonstrates an understanding of the pathophysiology, symptomology, investigation and treatment of specific diseases (Appendix 2/ Excel spreadsheet)

  • Efficiently gathers information from the patient, relatives and others by means of a medical history

  • Undertakes physical examination and elicits normal and abnormal findings

  • Makes informed, cost-effective decisions when ordering evidence based diagnostic tests, and interprets results in the context of the individual patient

  • Uses clinical reasoning to develop an appropriate differential diagnosis and identify related problems

  • Generates and initiates appropriate management plan for the patient in the context of the multidisciplinary team

  • Creates and maintains accurate, timely and legible medical records, and accurately presents findings to other healthcare professionals, communicating effectively in all media

  • Handles patient-identifiable information in a confidential manner

  • Prescribes medicines safely, economically and effectively, and is able to communicate important side effects and adverse events clearly to patients

  • Demonstrates competence in a range of clinical skills (Appendix 3) unsupervised and to a predetermined standard

  • Demonstrates an understanding of basic human factors principles and practice at individual, team, organisational and system levels and how these may impact patient care

  • Recognises complexity and uncertainty and appropriately manages risk in clinical practice

 

iii. Research and Medical Education:

The graduating doctor should use their knowledge of, and skills in, research methods and medical education to improve outcomes for patients. Specifically, the graduate:

  • Demonstrates an understanding of how research, audit, quality improvement and continuing professional development contribute to better outcomes for patients

  • Demonstrates the ability to formulate an appropriate research question, choose an appropriate study design including data collection and analysis taking account of ethical issues

  • Demonstrates an understanding of how to search for evidence

  • Demonstrates an understanding of the grading of research evidence and critically appraise a research report

  • Uses clinical judgement and critical appraisal skills when making informed, cost-effective decisions about ordering evidence based diagnostic and therapeutic interventions 

  • Demonstrates an ability to communicate research information clearly in written and spoken formats for varied audiences

  • Understands practice-based learning and quality improvement techniques. This includes routine self-evaluation and appraisal of current best practice, with consequent improvements in patient care provision

  • Effectively and appropriately provides teaching and mentorship for other learners in the multidisciplinary team including educational theories and assessment methods to match expected learning outcomes

  • Demonstrates the habit of life-long learning, making changes to own practice in response to evidence from own practice and research

  • Participates in the choice of suitable topics and methods of quality improvement including the use of audit period suggests changes to improve practice with the patient at the centre

  • Collect patient and colleague feedback and reflect on this as a learning opportunity

 

iv. Social and Behavioural Science:

The graduating doctor will be able to apply their understanding of psychological, social and cultural factors to provide effective and appropriate and sensitive healthcare for a diverse population.  Specifically, the graduate:

 

  • Demonstrates an understanding of normal physical, psychological and social development through the lifespan and appreciates how this may be impacted by illness.  Demonstrates an appreciation of how life stage may impact on doctor-patient relationship and adapts consultation style accordingly

  • Understands the physical, psychological, cultural and social factors that may influence the maintenance of health, the presentation and course of illness, and the outcomes of treatment

  • Demonstrates respect for patients’ health beliefs and ways of coping with illness, especially in regards to cultural and religious influences

  • Demonstrates an understanding of theories of health behaviour change, conditioning and personality, and the role of social support, motivation and self-efficacy in behaviour change. Applies this knowledge to design individualised health improvement plans

  • Weighs quantitative information such as risk, likelihood of beneficial and adverse outcomes, life expectancy, as well as qualitative factors, such as individual patients’ values and preferences and accommodates patient choice in management plans to help improve treatment concordance and compliance

  • Demonstrates an understanding of the context of their work in a complex social system comprising the patient, their relatives, the healthcare team and support organisations

  • Demonstrates an understanding of the principles of how to build teams and maintain effective team work and applies this to clinical practice

 

v. Community Health:

The graduating doctor demonstrates an understanding of public health theory and can apply this to their clinical practice.  Specifically, the graduate:

 

  • Recognises the wider determinants of health including health including economic, psychological, social, religious, historical, and cultural factors and how these contribute to health inequalities, both within Myanmar and globally

  • Demonstrates an understanding of the impact of health inequalities at the population and individual level, and supports the reduction of health disparity, especially as related to minority group individuals and underserved populations

  • Demonstrates an understanding of the use of epidemiological principles in assessing the health of the population and their applications to priority setting, resource allocation and service evaluation

  • Relates epidemiology and public health theory to the needs of communities in order support the reduction in incidence, prevalence and impact of ill health

  • Demonstrates an understanding of epidemiological study design and basic statistical concepts

  • Demonstrates an understanding of the services involved in promoting wellbeing, preventing illness, and protecting the health of the population

  • Demonstrates an understanding of strategies for primary, secondary and tertiary disease prevention

  • Demonstrates an understanding of the principles of screening for disease and pre-disease states

  • Demonstrates an understanding of the basic principles of health protection including disease surveillance, control of communicable and non-communicable diseases and emergency planning

 

vi. Family Medicine:

The graduating doctor is able to integrate the knowledge, skills and behaviours learned throughout the course and apply them in a clinical setting as appropriate for patients presenting with undifferentiated symptoms to ensure safe, compassionate and effective primary care. Specifically, the graduate:

 

  • Appropriately assesses the patient presenting with undifferentiated symptoms to make a safe differential diagnosis and institute appropriate management in a community setting

  • Differentiates between those who can be safely managed in the community and those who need specialist referral

  • Works to integrate patients’ care across different settings and disciplines to ensure person-centred care

  • Provides holistic care to patients based on a mutual understanding of their physical, psychological, emotional, and spiritual dimensions

  • Demonstrates the ability to build rapport and show empathy to communicate compassionately, effectively, and in culturally and emotionally appropriate ways, with patients, their families, colleagues and others involved in the care of their patients

  • Effectively manages the ‘difficult’ consultation including defusing aggression, breaking bad news and admitting lack of knowledge or mistakes

  • Demonstrates the ability to establish effective therapeutic relationships with patients and their families to provide reassurance, instil trust and maximise health outcomes

  • Applies understanding of preventative medicine in the community, including patient education, to promote good health for all individuals

  • Demonstrates proficiency in the identification and management of long term conditions in primary care according to relevant guidelines

  • Recognises risks and clinician responsibilities in remote consultations (e.g. telephone triage, video consultations) and institutes appropriate safeguards