GKT School of Medical Education - WhatDoTheyKnow...9. Outline th e basic mechanisms that underlie...

1 Document Owner: Head of Stage 1 Last Updated: 08 April 2016 Due for review: Current for 2016/17, due for review before 2017/18

GKT School of Medical Education

MBBS2020

Stage 1

Description

During stage 1, students will acquire a strong framework of basic science knowledge to support the concepts that underpin learning of pathology and pathophysiology that will be integrated with teaching and learning of clinical practice in stage 2. The teaching and learning environment will provide regular feedback on progress and promote the development of time management skills, self-reliance and confidence in judgement.

Stage 1 will occupy the first year of study in the curriculum. This stage of the programme will embrace 120 level 4 credits delivered in four modules which are described below.

Each module is comprised of a number of teaching blocks that emphasise one or more of the three learning

themes that underpin the programme as a whole:

Clinical practice (CP)

Population Sciences and Quality Improvement (PSQI)

Science and Discovery (S&D)

The module level learning outcomes are defined and the overarching graduation level learning outcomes of

the GMC document 'Outcomes for Graduates' and additional programme learning outcomes (appendix) to

which they contribute are indicated in parentheses.


Foundations of Biomedical Science 1 45 Credits

Description

Students will learn the basic knowledge and principles of biological sciences that provide the necessary foundation for future learning in clinical practice. These modules will focus upon normal structure and function in order for students to later understand how this is altered in the pathological stages of disease. The module will include teaching of molecular genetics and cell biology, communication within and between cells, anatomy and physiology of gastrointestinal, renal, urinary and hepatic systems, metabolism and nutrition.

Teaching Blocks

1. Functional Anatomy and embryology (S&D)

2. Cellular genetics and the Cell cycle (S&D)

3. Cell biology and signalling (S&D)

4. Nutrition and Metabolism (S&D)

5. Principles of Physiology and Pharmacology (S&D)

Additional Information

N/A

Pedagogy

Students will develop a deep knowledge of biomedical sciences by undertaking practical work in anatomy supported by consolidating material concerning the functional anatomy, biochemistry and physiology of systems. Learning will be achieved by a blended programme of traditional didactic methods such as group lectures and practical sessions supported by technology enhanced learning, e-learning and small group teaching designed to create a flexible environment for support of individual student learning and to encourage the students to take responsibility for their own learning.

Learning Outcomes

On completion of this module students will be able to :

1. Use appropriate terminology to identify and name the important anatomical features of the skeleton, major muscle groups and organs and relate these to their function in the organism as a whole. (8, 8a-e, g, 12)

2. Demonstrate the ability to apply basic numeracy skills appropriately in clinical and scientific contexts. (11c, 17, 17d, 12)

3. Demonstrate knowledge of the range of imaging technologies available currently and how these can be used to improve knowledge and understanding of anatomy especially in a clinical context. (8c-d, g, 12, 14d)

4. Outline how cells are organized structurally and functionally and recognize the distinctions of structure and function that lead to cell and tissue diversity.


(8, 8a-b, 12) 5. Describe how nucleic acids are made in cells and their role in storage and expression of genetic

information. (8, 8a-d, 11, 11a, 12)

6. Identify the main processes involved in cell division, differentiation and development of the embryo. (8, 8a-d, 12)

7. Identify the mechanisms that are used for communication within and between cells and the appropriate contexts for such communication e.g. intracellular signalling pathways, synaptic transmission, humoral communication, homeostatic regulation. (8, 8a-g, 12)

8. Describe the important molecular components of the systems and processes involved in cellular metabolism. (8, 8a-e, 11h, 12)

9. Outline the basic mechanisms that underlie intermediary metabolism and its regulation including carbohydrate, lipid, protein and nucleic acid metabolism. (8, 8a-e, 11h, 12)

10. Identify the importance of nutrition to health. (8, 8a-e, g, 11h)

11. Describe the normal regulation of energy balance and nutrient metabolism at the level of the whole body and tissues, and factors that influence them, including control of appetite. (8, 8a-e, g, 11h)

12. Recognize the fundamental physical quantities, principles and laws (such as pH, ionic equilibria, Ohm's law, Poiseuille's law) that underlie important biological processes (such as acid-base balance, membrane potential, physiological flow and pressure). (8, 8a-g, 12)

13. Describe the anatomy, mechanisms of function and physiological role of key organ systems including the gastrointestinal and urinary systems, the liver, kidneys and peripheral autonomic nervous system. (8, 8a-e, g, 12)

14. Describe the importance of maintaining the correct balance of water, solute and electrolyte concentrations in different cellular and tissue compartments. (8, 8a-e, g, 12)

Assessment

Written/Online Exams

Formative Paper 1: 0 credits

Formative Paper 2: 0 credits

Summative Paper 1: 45 credits

E-Portfolio/Portfolio

N/A


Doctor and Society and Introduction to Clinical Skills 30 Credits

Description

Students will be introduced to the basic skills of clinical practice in simulated clinical environments and they will be taught how to work in teams and communicate effectively with colleagues and with patients in order to deliver healthcare effectively. Key concepts for understanding population health issues and ideas for promoting quality improvement and the philosophical concepts that underlie them will be introduced. The complex legal, ethical socio-political and cultural context in which healthcare is delivered will be explored extensively and the paramount importance of professional behaviour as a framework for negotiating this complexity will be explained and stressed. Students will explore the social contract between doctors and society and what it means to be a member of the medical profession.

Teaching Blocks

1. Clinical Skills (CP)

2. Human Values – incorporating Professionalism, Medical Ethics, Clinical Communication,

Interprofessional Education, Medical Humanities, Cultural Competence and Student Wellbeing

and Resilience (CP, PSQI)

3. Healthcare in Britain (PSQI)

4. Philosophy (CP, PSQI)


N/A

Pedagogy

Learning will be achieved predominantly by small group teaching in simulated clinical environments supplemented by a blended programme of conventional didactic lectures, workshops and tutorials supported by appropriate use of Technology Enhanced Learning methods. Patient educators will be used to help students to develop confidence in taking a history and undertaking a physical examination. The students will thereby be set on a learning path that prepares them for studying in a supervised clinical environment that involves teamwork, professionalism, adherence to the law and demonstration of social responsibility.

Learning Outcomes


1. Demonstrate the ability to discern and analyse moral and legal issues in clinical practice. (10, 10a-b, 11, 11d, 13e-f, 14j, 17c, 20, 20a-g, 23c,d)

2. Demonstrate the virtues and respect for human values that are necessary for becoming a good doctor.


(20, 20a-g, 22c, 23, 23a, i-j) 3. Describe how clinical communication skills can be deployed effectively in patient care and

demonstrate their use in simulated clinical environments, written, telephone and electronic forms of communication. (13, 13g, 15, 15a-h, 19, 19a-e)

4. Demonstrate basic knowledge skills and attitudes of cultural competence. (14a, 15b, 20d-e)

5. Demonstrate understanding of patients’ lived experiences of the body, wellbeing and illness. (9, 9a-g, 10, 10a-e, 13, 14, 14e)

6. Demonstrate skills and understanding of concepts of sound argumentation, judgment and decision-making under uncertainty and ambiguity, and constructive disagreement and self-criticism. (7, 8g, 12a, 14a, d-f, 23b)

7. Demonstrate familiarity with tools found in the humanities and arts for interpretation of the complexity of human experience. (21, 21a-e)

8. Complete an accurate basic patient assessment. (8g, 13, 13a-g, 14, 14a-j, 16, 16a-e, 19, 19a, 20, 20a-d)

9. Provide basic first aid and immediate life support in medical emergencies. (16c-e)

10. Demonstrate an understanding of basic medicines management. (14g, 17, 17a-h, 19, 19a-b)

11. Demonstrate an understanding of ward-level infection control processes. (11e, 11g, 18, 18a-c, 23h)

12. Demonstrate safe and accurate performance of a list of clinical procedures. (14g, 15, 16, 16b-e, 18, 18a-c, 19a)

13. Describe the theory and evidence of effective team dynamics. (14f, j, 20d, 21d-e, 22, 22a-d)

14. Demonstrate understanding of safe and effective team working principles. (14f, j, 20d, 21d-e, 22, 22a-d)

15. Identify the various factors that contribute to error in the healthcare setting. (14f, 19a-e, 23d)

16. Describe the role and clinical responsibilities of a doctor. (20, 20a-g, Aa, Ab)

17. Describe the principles and concepts of professionalism. (20, 20a-g, 21, 21a-f, 22, 22a-d, 23, 23a-j, Aa-e)

18. Demonstrate the professional standards expected of a good Doctor. (20, 20a-g, 21, 21a-f, 22, 22a-d, 23, 23a-j, Aa-e)

19. Recognize the potential impact of personal health and well-being on professional performance and know when and how to seek help. (21c-f, 23f, i-j)

20. Describe the history and evolution of healthcare in the United Kingdom, and the social, economic, political and technological factors influencing its development. (11d, 20g, 23c, Aa-e)

21. Describe the administrative, financial and legal structure of the NHS, and the processes that underpin it. (11d, 13e, 20a, 20f-g, 23c, Ac-e)

22. Demonstrate an understanding of basic concepts of economics applied to health and health care and describe methods used to assess health care services using economic analysis. (10, 10b-d, 11, 11a-d)


Assessment


N/A


Satisfactory completion: 30 credits


Foundations of Biomedical Science 2 15 Credits

Description

Students will extend their knowledge and principles of biological sciences using an integrated approach to learning basic anatomy and physiology of the cardiovascular and respiratory systems The students will be introduced to basic concepts in pharmacology and learn the biological basis of infection and immunity. This knowledge will underpin their future understanding of disease processes in clinical medicine.

Teaching Blocks

1. Anatomy of Systems (S&D)

2. Pharmacology & Physiology of Systems (S&D)

3. Infection & immunity (S&D)


N/A

Pedagogy

Learning will be achieved by a blended programme of traditional didactic methods and practical sessions supported by technology enhanced learning, e-learning and small group teaching designed to create a flexible environment for support of individual student learning and to encourage the students to take responsibility for their own learning.

Learning Outcomes


1. Describe the normal anatomy and functional organisation of the thoracic region. (8, 8a-e, g)

2. Describe the basic anatomy and physiology of the cardiovascular and respiratory systems. (8, 8a-e, g)

3. Explain the principles of hematopoiesis and the basic functions of the main blood cell types. (8, 8a-e, g)

4. Describe the ABO and Rh D antigens and antibodies. (8, 8a-e, g)

5. Identify the main components and mechanisms involved in host cell defence and immunity, including the basic mechanism(s) of inflammation and how infective organisms such as viruses and bacteria can provoke inflammatory responses and immunity. (8, 8a-e, g)

6. Demonstrate a basic knowledge of microbes, their distinctive features and the relevance to humans and the environment, including their behaviour as pathogens. (8, 8a-e, g, 11e, 23h)

7. Outline the principal mechanisms of drug action and recognize the importance of pharmacokinetic properties of drugs.


(8, 8a-g, 17b, e, g)

Assessment


Summative Paper 2: Section A: 15 credits


N/A


Genes, Behaviour and the Environment 30 Credits

Description

In this module an introduction to population sciences and behavioural sciences will be integrated with further knowledge and learning of biological sciences focusing on cranial anatomy, neurosciences and genomics. Key aims will be to provide foundations for understanding the biological basis of behaviours and learning evidence-based approaches to interpretation of data and evaluation of risk. This will emphasise learning about the complex interplay of genes, behaviours and the environment and the opportunities to work with patients and the public to modify risk. Students will be set on the path of an integrated, patient-centred approach to medicine.

Teaching Blocks

1. Anatomy of the Head and Neck (S&D)

2. Introduction to Neurosciences, Behavioural & Social Science (S&D, PSQI)

3. Health Informatics & Evidence Based Practice (S&D, PSQI, CP)

4. Epidemiology & Biostatistics (S&D, PSQI)

5. Genomics (S&D, PSQI, CP)


N/A

Pedagogy

Learning will be achieved by a blended programme of traditional didactic methods such as group lectures and practical sessions supported by technology enhanced learning, e-learning and small group teaching. There will be an increased emphasis on small group teaching approaches supported by technology-enhanced learning as students develop skills in self-directed learning and acquire the confidence to assume control of their own learning.

Learning Outcomes


1. Describe the main types of research study; sources of bias and weakness. (8c-d, 11, 11a-c, 12, 12a-b, 23d-e)

2. Define and quantify measurement error in clinical diagnosis and diagnostic tests, including concepts of validity and reliability. (8c-d, 11, 11a-c, 12, 12a-b, 23d-e)

3. Describe the epidemiological method and main types of epidemiological study and other quantitative and qualitative research methods. (8c-d, 11, 11a-c, f, i-j, 12, 12a-b, 23d-e)

4. Understand simple statistical concepts (e.g. summarising data, significance tests) and describe their use in evaluation and presentation of evidence.


(8d, g, 11c, 11f, 12, 12a, c) 5. Describe patterns of lifestyle behaviours, genetic, environmental, cultural and socio-economic

determinants of health in a global context, and over time. (9, 9a-b, f, 10, 10a-e, 11, 11a-j)

6. Describe patterns of mortality, morbidity and disability globally, and over time. (9, 9a-g, 10, 10a-e, 11, 11a- j)

7. Describe the principles of evidence based practice and the key features of a scientifically valid guideline development process. (8,8c, d, g, 11, 11a-j, 12a-d, 19, 19d, e)

8. Describe the basic anatomy and physiology of the nervous system. 9. Describe the normal anatomy and functional organization of the head and neck region. 10. Describe sociological and psychological concepts and theories of illness behaviour, health beliefs,

behaviour change, and concordance. (9, 9a-g, 10, 10a-e)

11. Describe, compare and contrast different definitions of health and wellbeing and quality of life, explaining their social, cultural and professional context. (9a-b, 10a-e, 11a-b, j, 14a, f, 20b)

12. Identify molecular genetic characteristics that define similarities and differences between individuals. (8, 8a-b,12, 12a-c)

13. Recognize and describe the importance of informatics tools for the analysis and interpretation of data sets. (8d, 12a-c)

Assessment


Summative Paper 2: Section B: 15 credits


Satisfactory completion: 15 credits


Appendix

Extracted from Outcomes for Graduates:

Overarching outcome for graduates

7. Medical students are tomorrow’s doctors. In accordance with Good medical practice, graduates will make the care of patients their first concern, applying their knowledge and skills in a competent and ethical manner and using their ability to provide leadership and to analyse complex and uncertain situations.

Outcomes 1 − The doctor as a scholar and a scientist

8. The graduate will be able to apply to medical practice biomedical scientific principles, method and knowledge relating to: anatomy, biochemistry, cell biology, genetics, immunology, microbiology, molecular biology, nutrition, pathology, pharmacology and physiology. The graduate will be able to:

a. Explain normal human structure and functions. b. Explain the scientific bases for common disease presentations. c. Justify the selection of appropriate investigations for common clinical cases. d. Explain the fundamental principles underlying such investigative techniques. e. Select appropriate forms of management for common diseases, and ways of preventing common

diseases, and explain their modes of action and their risks from first principles. f. Demonstrate knowledge of drug actions: therapeutics and pharmacokinetics; drug side effects and

interactions, including for multiple treatments, long term conditions and non-prescribed medication; and also including effects on the population, such as the spread of antibiotic resistance.

g. Make accurate observations of clinical phenomena and appropriate critical analysis of clinical data.

9. Apply psychological principles, method and knowledge to medical practice.

a. Explain normal human behaviour at an individual level. b. Discuss psychological concepts of health, illness and disease. c. Apply theoretical frameworks of psychology to explain the varied responses of individuals, groups

and societies to disease. d. Explain psychological factors that contribute to illness, the course of the disease and the success of

treatment. e. Discuss psychological aspects of behavioural change and treatment compliance. f. Discuss adaptation to major life changes, such as bereavement; comparing and contrasting the

abnormal adjustments that might occur in these situations. g. Identify appropriate strategies for managing patients with dependence issues and other

demonstrations of self-harm.

10. Apply social science principles, method and knowledge to medical practice.

a. Explain normal human behaviour at a societal level. b. Discuss sociological concepts of health, illness and disease. c. Apply theoretical frameworks of sociology to explain the varied responses of individuals, groups and

societies to disease.


d. Explain sociological factors that contribute to illness, the course of the disease and the success of treatment − including issues relating to health inequalities, the links between occupation and health and the effects of poverty and affluence.

e. Discuss sociological aspects of behavioural change and treatment compliance. 11. Apply to medical practice the principles, method and knowledge of population health and the

improvement of health and healthcare.

a. Discuss basic principles of health improvement, including the wider determinants of health, health inequalities, health risks and disease surveillance.

b. Assess how health behaviours and outcomes are affected by the diversity of the patient population. c. Describe measurement methods relevant to the improvement of clinical effectiveness and care. d. Discuss the principles underlying the development of health and health service policy, including

issues relating to health economics and equity, and clinical guidelines. e. Explain and apply the basic principles of communicable disease control in hospital and community

settings. f. Evaluate and apply epidemiological data in managing healthcare for the individual and the

community. g. Recognise the role of environmental and occupational hazards in ill-health and discuss ways to

mitigate their effects. h. Discuss the role of nutrition in health. i. Discuss the principles and application of primary, secondary and tertiary prevention of disease. j. Discuss from a global perspective the determinants of health and disease and variations in

healthcare delivery and medical practice.

12. Apply scientific method and approaches to medical research.

a. Critically appraise the results of relevant diagnostic, prognostic and treatment trials and other qualitative and quantitative studies as reported in the medical and scientific literature.

b. Formulate simple relevant research questions in biomedical science, psychosocial science or population science, and design appropriate studies or experiments to address the questions.

c. Apply findings from the literature to answer questions raised by specific clinical problems. d. Understand the ethical and governance issues involved in medical research.

Outcomes 2 − The doctor as a practitioner

13. The graduate will be able to carry out a consultation with a patient:

a. Take and record a patient’s medical history, including family and social history, talking to relatives or other carers where appropriate.

b. Elicit patients’ questions, their understanding of their condition and treatment options, and their views, concerns, values and preferences.

c. Perform a full physical examination. d. Perform a mental-state examination. e. Assess a patient’s capacity to make a particular decision in accordance with legal requirements and

the GMC’s guidance. f. Determine the extent to which patients want to be involved in decision-making about their care and

treatment. g. Provide explanation, advice, reassurance and support.

14. Diagnose and manage clinical presentations.


a. Interpret findings from the history, physical examination and mental-state examination, appreciating

the importance of clinical, psychological, spiritual, religious, social and cultural factors. b. Make an initial assessment of a patient’s problems and a differential diagnosis. Understand the

processes by which doctors make and test a differential diagnosis. c. Formulate a plan of investigation in partnership with the patient, obtaining informed consent as an

essential part of this process. d. Interpret the results of investigations, including growth charts, x-rays and the results of the

diagnostic procedures in Appendix 1. e. Synthesise a full assessment of the patient’s problems and define the likely diagnosis or diagnoses. f. Make clinical judgements and decisions, based on the available evidence, in conjunction with

colleagues and as appropriate for the graduate’s level of training and experience. This may include situations of uncertainty.

g. Formulate a plan for treatment, management and discharge, according to established principles and best evidence, in partnership with the patient, their carers, and other health professionals as appropriate. Respond to patients’ concerns and preferences, obtain informed consent, and respect the rights of patients to reach decisions with their doctor about their treatment and care and to refuse or limit treatment.

h. Support patients in caring for themselves. i. Identify the signs that suggest children or other vulnerable people may be suffering from abuse or

neglect and know what action to take to safeguard their welfare. j. Contribute to the care of patients and their families at the end of life, including management of

symptoms, practical issues of law and certification, and effective communication and teamworking.

15. Communicate effectively with patients and colleagues in a medical context.

a. Communicate clearly, sensitively and effectively with patients, their relatives or other carers, and colleagues from the medical and other professions, by listening, sharing and responding.

b. Communicate clearly, sensitively and effectively with individuals and groups regardless of their age, social, cultural or ethnic backgrounds or their disabilities, including when English is not the patient’s first language.

c. Communicate by spoken, written and electronic methods (including medical records), and be aware of other methods of communication used by patients. The graduate should appreciate the significance of non-verbal communication in the medical consultation.

d. Communicate appropriately in difficult circumstances, such as when breaking bad news, and when discussing sensitive issues, such as alcohol consumption, smoking or obesity.

e. Communicate appropriately with difficult or violent patients. f. Communicate appropriately with people with mental illness. g. Communicate appropriately with vulnerable patients. h. Communicate effectively in various roles, for example, as patient advocate, teacher, manager or

improvement leader.

16. Provide immediate care in medical emergencies.

a. Assess and recognise the severity of a clinical presentation and a need for immediate emergency care.

b. Diagnose and manage acute medical emergencies. c. Provide basic first aid. d. Provide immediate life support.


e. Provide cardio-pulmonary resuscitation or direct other team members to carry out resuscitation.

17. Prescribe drugs safely, effectively and economically.

a. Establish an accurate drug history, covering both prescribed and other medication. b. Plan appropriate drug therapy for common indications, including pain and distress. c. Provide a safe and legal prescription. d. Calculate appropriate drug doses and record the outcome accurately. e. Provide patients with appropriate information about their medicines. f. Access reliable information about medicines. g. Detect and report adverse drug reactions. h. Demonstrate awareness that many patients use complementary and alternative therapies, and

awareness of the existence and range of these therapies, why patients use them, and how this might affect other types of treatment that patients are receiving.

18. Carry out practical procedures safely and effectively.

a. Be able to perform a range of diagnostic procedures, as listed in Appendix 1 and measure and record the findings.

b. Be able to perform a range of therapeutic procedures, as listed in Appendix 1. c. Be able to demonstrate correct practice in general aspects of practical procedures, as listed in

Appendix 1.

19. Use information effectively in a medical context.

a. Keep accurate, legible and complete clinical records. b. Make effective use of computers and other information systems, including storing and retrieving

information. c. Keep to the requirements of confidentiality and data protection legislation and codes of practice in

all dealings with information. d. Access information sources and use the information in relation to patient care, health promotion,

giving advice and information to patients, and research and education. e. Apply the principles, method and knowledge of health informatics to medical practice.

Outcomes 3 − The doctor as a professional

20. The graduate will be able to behave according to ethical and legal principles. The graduate will be able to:

a. Know about and keep to the GMC’s ethical guidance and standards including Good medical practice, the ‘Duties of a doctor registered with the GMC’ and supplementary ethical guidance which describe what is expected of all doctors registered with the GMC.

b. Demonstrate awareness of the clinical responsibilities and role of the doctor, making the care of the patient the first concern. Recognise the principles of patient centred care, including self-care, and deal with patients’ healthcare needs in consultation with them and, where appropriate, their relatives or carers.

c. Be polite, considerate, trustworthy and honest, act with integrity, maintain confidentiality, respect patients’ dignity and privacy, and understand the importance of appropriate consent.

d. Respect all patients, colleagues and others regardless of their age, colour, culture, disability, ethnic or national origin, gender, lifestyle, marital or parental status, race, religion or beliefs, sex, sexual


orientation, or social or economic status. Graduates will respect patients’ right to hold religious or other beliefs, and take these into account when relevant to treatment options.

e. Recognise the rights and the equal value of all people and how opportunities for some people may be restricted by others’ perceptions.

f. Understand and accept the legal, moral and ethical responsibilities involved in protecting and promoting the health of individual patients, their dependants and the public − including vulnerable groups such as children, older people, people with learning disabilities and people with mental illnesses.

g. Demonstrate knowledge of laws, and systems of professional regulation through the GMC and others, relevant to medical practice, including the ability to complete relevant certificates and legal documents and liaise with the coroner or procurator fiscal where appropriate.

23. Reflect, learn and teach others.

a. Acquire, assess, apply and integrate new knowledge, learn to adapt to changing circumstances and ensure that patients receive the highest level of professional care.

b. Establish the foundations for lifelong learning and continuing professional development, including a professional development portfolio containing reflections, achievements and learning needs.

c. Continually and systematically reflect on practice and, whenever necessary, translate that reflection into action, using improvement techniques and audit appropriately − for example, by critically appraising the prescribing of others.

d. Manage time and prioritise tasks, and work autonomously when necessary and appropriate. e. Recognise own personal and professional limits and seek help from colleagues and supervisors when

necessary. f. Function effectively as a mentor and teacher including contributing to the appraisal, assessment and

review of colleagues, giving effective feedback, and taking advantage of opportunities to develop these skills.

22. Learn and work effectively within a multi-professional team.

a. Understand and respect the roles and expertise of health and social care professionals in the context of working and learning as a multi-professional team.

b. Understand the contribution that effective interdisciplinary teamworking makes to the delivery of safe and high-quality care.

c. Work with colleagues in ways that best serve the interests of patients, passing on information and handing over care, demonstrating flexibility, adaptability and a problem-solving approach.

d. Demonstrate ability to build team capacity and positive working relationships and undertake various team roles including leadership and the ability to accept leadership by others.

23. Protect patients and improve care.

a. Place patients’ needs and safety at the centre of the care process. b. Deal effectively with uncertainty and change. c. Understand the framework in which medicine is practised in the UK, including: the organisation,

management and regulation of healthcare provision; the structures, functions and priorities of the NHS; and the roles of, and relationships between, the agencies and services involved in protecting and promoting individual and population health.

d. Promote, monitor and maintain health and safety in the clinical setting, understanding how errors can happen in practice, applying the principles of quality assurance, clinical governance and risk


management to medical practice, and understanding responsibilities within the current systems for raising concerns about safety and quality.

e. Understand and have experience of the principles and methods of improvement, including audit, adverse incident reporting and quality improvement, and how to use the results of audit to improve practice.

f. Respond constructively to the outcomes of appraisals, performance reviews and assessments. g. Demonstrate awareness of the role of doctors as managers, including seeking ways to continually

improve the use and prioritisation of resources. h. Understand the importance of, and the need to keep to, measures to prevent the spread of

infection, and apply the principles of infection prevention and control. i. Recognise own personal health needs, consult and follow the advice of a suitably qualified

professional, and protect patients from any risk posed by own health. j. Recognise the duty to take action if a colleague’s health, performance or conduct is putting patients

at risk.

Additional Programme Learning Outcomes:

The Ethical and Legal Framework of Clinical Practice

Aa. Describe the GMC’s ethical guidance and standards including Good Medical Practice, the ‘Duties of a doctor registered with the GMC’ and supplementary ethical guidance which describe what is expected of all doctors registered with the GMC (based on Outcomes for Graduates:20a)

Ab. Describe the laws, and systems of professional regulation through the GMC and others, relevant to medical practice, including the ability to complete relevant certificates and legal documents and liaise with the coroner where appropriate (based on Outcomes for Graduates:20g)

The History, Values and Organization of the NHS

Ac. Outline the history of the NHS and the principles of the NHS Constitution

Ad. Describe the organization, management and regulation of healthcare provision (based on Outcomes for Graduates:23c)

Ae. Discuss the structures, functions and priorities of the NHS; and the roles of, and relationships between, the agencies and services involved in protecting and promoting individual and population health (based on Outcomes for Graduates:23c)

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