Table 3.
Description of the EPA “Conducting an internal medicine ward round” (short version) with competences, sub-competences and related CanMEDS roles
| Discipline | Internal Medicine | |
|---|---|---|
| Title | Conducting a ward round in internal medicine | |
| Description | Conducting the daily ward round in an internal medicine department, starting with the preparation. | |
| CanMEDS domains of competence | Communicator (Com), Medical Expert (ME), Manager (M), Collaborator (Coll), Professional (P), Scholar (S) | |
| Competences and sub-competences | CanMEDS domains of competences | LoSa |
| Diagnostic process and therapy planning (including adequate communication) | Com, ME, Coll, M | |
| - Capability to gather information about the patient including different information such as medical records, communication with patient and team and focused physical examination. | ||
| - Capability to analyse given information. | ||
| - Capability to make decisions with the patient about his/her further treatment and discharge from hospital in a time efficient way. | ||
| - Capability to exchange information with the ward round team before and after the ward round, including documentation in patient’s record. | ||
| - Capability to inform the patient about further treatment and discharge from hospital. | ||
| Empathy (including adequate communication) | Com | |
| - Capability to recognize the necessity for empathy in physician-patient interaction. | ||
| - Capability to be empathetic in physician-patient interaction, if necessary. | ||
| Leadership skills (including adequate communication) | Com, Coll, M | |
| - Capability to involve the team in the ward round process. | ||
| - Capability to assign tasks to team members. | ||
| - Capability to lead the patient especially via communication. | ||
| Management of difficult situations and faults (including adequate communication) | Coll, M | |
| - Capability to recognize, assess and react to interruptions of the ward round. | ||
| - Capability to recognize, assess and react to ward round faults. | ||
| - Capability to recognize and react to conflicts within the team in the course of the ward round. | ||
| - Capability to recognize and react to conflicts with the patient in the course of the ward round. | ||
| Organization competence (including adequate communication) | Com, Coll, M | |
| - Capability to ensure a structured ward round process including preparation, consultation with the patient and the team. | ||
| - Capability to ensure a sufficient time management by adapting the duration of the ward round to patient’s needs as well as on the occurrences of the day, focusing on relevant aspects in physician-patient communication and avoiding interruptions. | ||
| Professionalism (including adequate communication) | Com, Coll, P | |
| - Capability to ensure reliable behaviour towards the team and the patient. | ||
| - Capability to ensure a respectful physician-patient relationship. | ||
| - Capability to be aware of one’s own facial expression and gestures. | ||
| - Capability to adapt one’s usage of language. | ||
| Self-management | ME, Coll, S | |
| - Capability to assess own personal and professional limits, and to react if necessary. | ||
| - Capability to assess own actions in a self-critical way. | ||
| - Capability to remain calm and professional in difficult situations. | ||
| Teaching and learning abilities (including adequate communication) | S | |
| - Capability to convey knowledge to students by involving them in the ward round process and discussing patient cases. | ||
| - Capability to improve own knowledge through reflection of the ward round, in total or in specific cases. | ||
| Assessment procedure | Conducting a ward round in a training environment with self- reflection and feedback. | |
aLoS = Level of supervision: (1) Observation but no execution, even with direct supervision, (2) Execution with direct, proactive supervision, (3) Execution with reactive supervision, i.e., on request and quickly available, (4) Supervision at a distance and/or post hoc, (5) Supervision provided by the trainee to more junior colleagues [18]