Curriculum Implementation Support Program

Attitude Ethics and Communication

(AETCOM)

© Academic Cell, Medical Council of India. 2019

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 Graduate Medical Regulations

“Indian Medical Graduate” (IMG) possessing requisite

knowledge, skills, attitudes, values and responsiveness, so
that he or she may function appropriately and effectively as a
physician of first contact of the community
while being globally relevant.
Revised Regulations on Graduate Medical Education,
“Indian Medical Graduate” ROLES

Clinician - preventive, promotive, curative, palliative and holistic

care with compassion.
 Leader and member of the health care team -
collect analyze, synthesize and communicate health data
 Communicator - patients, families, colleagues and community.
 Lifelong learner - continuous improvement.
 Professional - ethical, responsive and accountable.
How it is being learnt now?

My Teacher

Through

Hidden curriculum
The hidden curriculum

The hidden curriculum consists of

those things the students learn through the
experience of attending college
rather than the stated
educational objectives of such institutions.
PLANNED DELIVERED

EXPEERIENCED
EXPEERIENCED
 explicit part

implicit part
Teach by example
Attitude - Teaching ?
 Modules
 Role play
 Feed Back
 Project work
 Field trips
 Medical camps
 Voluntary services
 NCC NSS
Movie clips
 Attitude, communication

Classical approach
Vs
Direct and explicit teaching

What and How to teach?

Deriving from participants
Attitude and Communication (AT-COM) Module
Section I: Extract of goals, roles and universal competencies as
envisaged by I MG document.
 
Section II: Suggested teaching modules for each professional
year , resources cases and method to teach 

Section III: List of additional non-core competencies that form a

desirable set of learning 

Section IV: Competency log - in a simulated setting .

- progressing in complexity over time. 
Attitude and Communication (AT-COM) Module
Section V: Formative elements that are observable by guides
and marked over time. 
 
Appendix 1: Set of competencies as approved by the Academic
Committee of the Medical Council of India
 
Appendix 2: Modified communication skill rating tool adapted
from the Kalamazoo consensus
Learning modules for Professional year I
Number of Modules: 5 Number of hours: 34

1. What does it mean to be a doctor?

BACKGROUND
It is important for new entrants to get a holistic view of their profession, its ups and downs, its
responsibilities and its privileges.
It is important to start this discussion early in their careers when their minds are still fresh with the
thrill of joining medical school.
Such a discussion will help them remember the big picture through the program and remind them
why they have chosen to be doctors.

LEARNING EXPERIENCE
When: Professional year 1
Hours: 8 (6 hours + 2 hours self directed learning) This session can be delivered by
4 inter-dependent learning experiences
Learning modules for Professional year I

1. An exploratory session with the students enquiring from them

Why they chose to become doctors and what do they think are the
privileges and the responsibilities of the profession.
What do they expect from society and what do they think society
expects from them?
What will they have to do and give up in order to meet
their own and society’s expectations.

This is preferably done in a small group discussion.

2. A facilitated panel discussion involving doctors who are at various stages of their
careers (senior, midlevel, young) where doctors share their experiences and also answer
questions from students.
Learning modules for Professional year I
3. Self directed learning where students write a report from
reflection based on sessions 1 & 2 and on other readings, TV series movies etc that
they have chosen from the lay press about doctor experiences.

4. Introductory visit to the hospital / community medical centres

5. A closure session with students to share their reflections based

on 1, 2, 3 and 4 that includes what they plan to do in the next 5 years
in order to fulfill their professional and personal roles as doctors.

6. A white coat ceremony in the Foundation Course.

RESOURCES
Whitcomb ME. Academic Medicine 2007 82: 917
 Communication skill
Doctor – Patient / Attendants
Applications in Medical Education

List the communication skills required to be taught to a UG

Derive from participants

 Doctor – Patient encounter
1. Building the doctor patient relationship

2. Opening the discussion

3. Gathering information

4. Understanding the patient’s perspective

5. Sharing information

6. Reaching agreement on problems and plans

 Breaking a bad news
Goals of the Bad News Interview

 To provide intelligible information and educate the pt / attendents

regarding the disease process.
 To support the patient by employing skills to reduce the emotional impact
 To develop a strategy in the form of a treatment plan with the input and
cooperation of the patient.
 To support the relatives / attendents in accepting the event.
 SPIKES- Six- Step Protocol
for Delivering Bad News
Step 1: S- Setting Up The Interview
Step 2: P- Assessing The Patient’s Perception
Step 3: I- Obtaining The Patient’s Invitation
Step 4: K- Giving Knowledge And Information To The Patient
Step 5: E- Addressing The Patient’s Emotions With Empathic
Responses
Step 6: S- Strategy and Summary