9/12/2021

Introductions
Dr. Mazhar Mushtaq
CoRe – Coordinator

Medical Curriculum
 Knowledge

 Skills
 Physical Examination
 Communication

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Physical Examination Communication

Consultation Reflection

http://www.youtube.com/watch?v=
cDDWvj_q-o8#action=share

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CORE TUTORS
Male Section Female Section
Prof. Khawaja Husnain Haider. Dr. Doaa Zineldeen
Prof. Zia Iqbal. Dr. Noor Shahliza
Dr. Hany Lotfy. Prof. Inas Abdul Aziz
Dr. Ahmed Husneen. Dr. Heba Shoukry
Dr. Abdul Mateen. Dr. Dalia Magdi
Dr. Eman Anwar
Dr. Ihab Herbi.
Dr. Abdul Rehman Khan.
Dr. Mazhar Mushtaq.

CORE teaching is about -- Consulting with patients

CoRe

Consultation  How do I go with patients, how do I use knowledge and skills.

Reflection  Reflect upon your self (How well were you connected with patient)

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Reflect on consultation
 Assessment of your own performance

 Receive feedback by group members

 Building on each other’s feedback

 How you can improve.

CoRe
Longitudinal training

Year 1

Year 2

Year 3

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Purpose
Create doctors that
communicate with
patients in a
professional way

Make sure that doctors

deal with the right problem
of the patient; prevent
medical errors

Method
Practice communication skills during Simulated Patient Contacts (SPCs)

One student plays doctor and another plays Simulated Patient (SP)

Two to four students observe the SPC

Write down feedback based on Maas-Global list

Discuss feedback with doctor after consultation

SP gives feedback as well

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Observer Teacher

Patient Doctor

Phases during CORE

Opening
Clarification of the problem
History taking
Physical examination
Evaluation and diagnosis
Policy and appointments
Consultation evaluation
Summarizing, paraphrasing
Logical sequence of phases
Sufficient room for patient
Explorative question
Providing information
Emotions
Empathy

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Communication Skills according to Maas-Globaal

Consult the descriptions of the items in the MAAS-Globaal criteria list. The score-squares of the items are
GENERAL COMMUNICATION SKILLS
solely for notation purposes to aid memory. For each item, tick the circle for the score that applies. g p a f b n
8 EXPLORATIVE QUESTIONING + - (34) O O O O O O
Score options: Open (continuing) questioning in
good pass average fail bad not patient’s frame of reference
Abbreviated: g p a f b n Responding to nonverbal behaviour
and key words
COMMUNICATION SKILLS PER PHASE During problem
g p a f b n clarification, diagnosis
1 OPENING + - (27) O O O O O O and policy
Greeting: attentive and inviting g p a f b n
Own name and position 9 PROVIDING INFORMATION + - (35) O O O O O O
Finding out reason for coming Announcing, categorizing
g p a f b n Small quantities, concrete
2 CLARIFICATION OF THE + - (28) O O O O O O explanation
PROBLEM Everyday language
Stating problems, Check if information is understood
wishes and expectations g p a f b n
Stating reason for current visit 10 EMOTIONS + - (36) O O O O O O
g p a f b n Asking (more) about emotions
3 HISTORY-TAKING + - (29) O O O O O O Reflection of emotions (including
Explanation working method nature and intensity)
Direct questioning Sufficient throughout consultation
Varied and inviting Processing of responses: first
g p a f b n addressing emotions
4 PHYSICAL EXAMINATION + - (30) O O O O O O g p a f b n
Instructing patient 11 + - (37) O O O O O O
SUMMARIZING (by summarizing,
Indicating what is going to be
examined paraphrasing, repeating)
Treating patient carefully and with Concise, in own words
respect Content accurate, complete
g p a f b n Checking accuracy
Sufficient throughout consultation
5 EVALUATION AND DIAGNOSIS + - (31) O O O O O O
Stating findings and g p a f b n
12 STRUCTURE + - (38) O O O O O O
diagnosis/hypothesis
Logical sequence of phases
Stating causes Balanced distribution of time
or relation between findings and Announcements (consultation plan,
diagnosis history-taking, examination, other
Stating prognosis or expected phases)
developments g p a f b n
g p a f b n 13 EMPATHY/FLEXIBILITY + - (39) O O O O O O
6 POLICY AND APPOINTMENTS + - (32) O O O O O O
Empathetic attitude, attentive and
Consultation regarding policy
Discussion of feasibility and follow-up inviting in tone, gesture and eye
behaviour contact
Appointments: who, what, when Sufficient room for patient
g p a f b n No disturbing hesitation or
7 CONSULTATION EVALUATION + - (33) O O O O O O interruptions
General question
Answering problems
Preliminary perspective ───────────────────────────────────────
OTHER FEEDBACK

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Prepare consultation
Learning Goals (LG) based on feedback previous CORE meeting:

LG 1: I want to:
I expect to achieve this by:

LG 2: I want to:
I expect to achieve this by:

Indicate how you have prepared yourself for THIS SIMULATED PATIENT CONTACT

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Report consultation
Make up your report according to SOEP method

Subjective Objective Evaluation Plan

S
Report patient’s reason for contact
Report your impression of the patient

O
Report patient’s history
Report examination done

E Report hypothesis

P Report diagnosis and proposed policy

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Practical information
One student plays doctor, other plays SP

After playing doctor, roles change

During the next SPC, two of the observers from last SPC play
doctor/SP  everyone gets each role (doctor, SP or observer)

DOCTOR
In first year limited medical knowledge
Role student:

GP was called out for an emergency

Asked you to conduct the first part of the consultation with this patient

Then you can pass on this information to the GP

You can gradually expand the role

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ALL student will present 3 CORE/Year.

Each CORE session will be LIVE.
CORE report submission will be end of specified blocks.
Dedicated Time as specified in the block timetable.
CORE Attendance is MANDATORY.
(Just like PBL it will be marked in the system.)
80% is MUST or Your final grade will not be processed

No CORE will be accepted after due date.

CORE sessions in an Academic Block.

Block of 8 weeks will have 4 CORE Session.

Block of 4 weeks will have 2 CORE Session.

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Introduction to CORE by CORE coordinator - NOW

Block 1.1

Discussion with the students about the method of CORE and

share some previous videos. Also discuss the cases uploaded on
e-learning in the respective group

FINAL CORE Submission

CORE # 1st Year
1st CORE End of 1.1

2nd CORE End of 1.2

3rd CORE End of 1.4

End of block mean LAST Week

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!! Who will be your TUTOR !!

Groups will be notified on E-Learning

along with tutor’s name CORE TUTOR
(Not necessarily the PBL tutors)
TUTOR will remain the same till your CORE submission
Your Tutor will NOT be responsible if the submission date
has passed and he/she was unable to sign, because of his
busy schedule.
It is your duty to get it sign as early as possible.

Student should submit following items to the tutor at

or before the submission date;
 CoRe report form signed by tutor
 Four feedback forms including tutor.
 CoRe Professional Behavior form
Whom to submit
Submit to your tutors:
Reports + Feedback of ALL THREE CoRe
Before the Dead LINE. (End of 2.4)
No Extension in the Dead Line

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All Detail in E-Learning.

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At the end of 1st year students will be able to:

CORE 1
Know,  how to greet with the patient and make introduction with them.
Obtain  history of patient by explaining working method and direct questioning.
State  the problem of the patient and purpose of the visit.

Core 2
Explore further by asking open questions from the patient.
Explain  the problem to the patient in everyday language.

Core 3
Summarize  the problem in concise and his own words.
Formulate  the problem in logical sequence.

Final Grading
•3 A+ = A+ •2 B+ + 1 C+ = C+

•2 A+ + 1 B+ = A+ •1 B+ + 2 C+ = C+

•1A+ + 2 B+ = B+ •3 C+ = C+

•3 B+ = B+ • C+ + D+ + B = C+
F means Fail in CORE • 2A+ + C+ = B+

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Consultation
A “conversation” between;

the person asking care (“the patient”)

and
the (professional) person providing care

to
solve a (medical) problem.

Consultation
A patient always has two ‘issues’:

A (medical) problem (e.g. headache)

AND

A QUESTION related to the problem (e.g. Should I

be worried about it?, Do I want to take drugs
against it?)

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The capacity to recognise emotions

that are being felt by another
person.
Patient: I am having headache for the last two days
Patient: I am having headache for the last two days

Doctor: I can very well understand your situation, some

time headache
Doctor: arework
OK!!! we will very itbad.
out BUT We will work it out

Consultation

Remember: it is NOT SUFFICIENT to ONLY identify the problem:

YOU SHOULD ALWAYS FIND OUT THE QUESTION BEHIND

THE PROBLEM

In other words:
Find an answer to a question

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