"Entry to Residency" "Transition to Discipline" "Foundations of Discipline" "Core of Discipline" "Transition to Practice" "Advanced Expertise" "Communicator" "1 Establish professional therapeutic relationships with patients and their families" "1.1 Communicate using a patient-centred approach that encourages patient trust and autonomy and is characterized by empathy, respect, and compassion" "Describe the key components of a patient-centred approach to medical care Outline the evidence that effective physician–patient communication enhances patient and physician outcomes" "Communicate using a patient-centred approach that facilitates patient trust and autonomy and is characterized by empathy, respect, and compassion" "Teach and assess the patient-centred approach to communication" "1.2 Optimize the physical environment for patient comfort, dignity, privacy, engagement, and safety" "Describe elements of the physical environment that affect patient comfort, dignity, privacy, engagement, and safety" "Mitigate physical barriers to communication to optimize patient comfort, dignity, privacy, engagement, and safety" "Optimize the physical environment for patient comfort, dignity, privacy, engagement, and safety" "Participate in institutional/system initiatives to improve the physical environment for patients" "1.3 Recognize when the values, biases, or perspectives of patients, physicians, or other health care professionals may have an impact on the quality of care, and modify the approach to the patient accordingly" "Describe how patient and physician values, biases, and perspectives can affect clinical encounters" "Recognize when the values, biases, or perspectives of patients, physicians, or other health care professionals may have an impact on the quality of care, and modify the approach to the patient accordingly" "Teach learners to recognize situations in which patient and physician values, biases, or preferences may threaten the quality of care, and how to modify the approach to patient care" "1.4 Respond to a patient’s non-verbal behaviours to enhance communication" "Identify non-verbal communication from a patient and family and its impact on physician–patient communication Describe how to utilize non-verbal communication to build rapport" "Identify, verify, and validate non-verbal cues on the part of patients and their families Use appropriate non-verbal communication to demonstrate attentiveness, interest, and responsiveness to the patient and family" "Respond to patients’ non-verbal communication and use appropriate non-verbal behaviours to enhance communication with patients" "Demonstrate advanced non-verbal communication skills in difficult situations" "1.5 Manage disagreements and emotionally charged conversations" "Describe physician, patient, and contextual factors that lead to strong emotions Describe how strong emotions may affect the patient–physician interaction Critically reflect upon emotional encounters and identify how different approaches may have affected the interaction" "Recognize when personal feelings in an encounter are valuable clues to the patient’s emotional state" "Recognize when strong emotions (such as, anger, fear, anxiety, or sadness) are affecting an interaction and respond appropriately Establish boundaries as needed in emotional situations" "Manage disagreements and emotionally charged conversations" "Teach others to anticipate, recognize, and manage emotions in routine clinical encounters" "1.6 Adapt to the unique needs and preferences of each patient and to his or her clinical condition and circumstances" "Describe models of decision-making along the spectrum from “paternalistic” to “shared” to “autonomous” Describe the importance of capacity assessment Assess and appropriately address the patient’s preferred involvement in decisions about care" "Assess a patient’s decision-making capacity" "Tailor approaches to decision-making to patient capacity, values, and preferences" "Adapt to the unique needs and preferences of each patient and to his or her clinical condition and circumstances" "Teach others to tailor approaches to decision-making to patient capacity, values, and preferences" "2 Elicit and synthesize accurate and relevant information, incorporating the perspectives of patients and their families" "2.1 Use patient-centred interviewing skills to effectively gather relevant biomedical and psychosocial information" "Describe the basic elements of the patient-centred interview Conduct a patient-centred interview under supervision, gathering relevant biomedical and psychosocial information in the context of an uncomplicated presentation of a common medical problem" "Conduct a patient-centred interview, gathering all relevant biomedical and psychosocial information for any clinical presentation Integrate and synthesize information about the patient’s beliefs, values, preferences, context and expectations with biomedical and psychosocial information" "Actively listen and respond to patient cues Integrate, summarize, and present the biopsychosocial information obtained from a patient-centred interview" "Use patient-centred interviewing skills to effectively gather relevant biomedical and psychosocial information" "Intervene when, during the patient interview, a learner or health care professional ignores the patient’s beliefs, values, preferences, context, or expectations" "2.2 Provide a clear structure for and manage the flow of an entire patient encounter" "Conduct a patient encounter using an organizing framework" "Conduct a focused and efficient patient interview, managing the flow of the encounter while being attentive to the patient’s cues and responses" "Manage the flow of challenging patient encounters, including those with angry, distressed, or excessively talkative individuals" "Provide a clear structure for and manage the flow of an entire patient encounter" "2.3 Seek and synthesize relevant information from other sources, including the patient’s family, with the patient’s consent" "Describe potential sources of information that may assist in a given patient’s care" "Seek and synthesize relevant information from other sources, including the patient’s family, with the patient’s consent" "3 Share health care information and plans with patients and their families" "3.1 Share information and explanations that are clear, accurate, and timely, while checking for patient and family understanding" "Describe the ethical principles of truth-telling in the physician–patient relationship" "Communicate the diagnosis, prognosis and plan of care in a clear, compassionate, respectful, and accurate manner to the patient and family Recognize when to seek help in providing clear explanations to the patient and family" "Use strategies to verify and validate the understanding of the patient and family with regard to the diagnosis, prognosis, and management plan" "Provide information on diagnosis and prognosis in a clear, compassionate, respectful, and objective manner Convey information related to the patient’s health status, care, and needs in a timely, honest, and transparent manner" "Communicate clearly with patients and others in the setting of ethical dilemmas" "3.2 Disclose harmful patient safety incidents to patients and their families accurately and appropriately" "Describe the ethical, professional, and legal obligations, and policies for, disclosure and reporting of patient safety incidents" "Describe the steps in providing disclosure after a patient safety incident" "Communicate the reasons for unanticipated clinical outcomes to patients and disclose patient safety incidents Apologize appropriately for a harmful patient safety incident" "Disclose patient safety incidents to the patient and family accurately and appropriately Plan and document follow-up to harmful patient safety incident" "Lead disclosure teams Conduct peer review and practice assessments related to unexpected clinical outcomes and patient safety incidents Contribute to the improvement of the system of disclosure for patient safety incidents" "4 Engage patients and their families in developing plans that reflect the patient’s health care needs and goals" "4.1 Facilitate discussions with patients and their families in a way that is respectful, non-judgmental, and culturally safe" "Describe the principles of cross-cultural interviewing Demonstrate interviewing techniques for encouraging discussion, questions, and interaction Conduct culturally safe interviews with close supervision Describe steps for conducting an interview with a translator" "Conduct an interview, demonstrating cultural awareness" "Explore the perspectives of the patient and others when developing care plans Communicate with cultural awareness and sensitivity" "Facilitate discussions with the patient and family in a way that is respectful, non-judgmental, and culturally safe" "Teach others and assess their ability to engage patients in a way that is respectful and non-judgmental and that provides cultural safety" "4.2 Assist patients and their families to identify, access, and make use of information and communication technologies to support their care and manage their health" "Describe the various technologies and information sources available to enhance patients’ understanding and management of their health care" "Assist the patient and family to identify, access, and make use of information and communication technologies to support care and manage health" "Contribute to the development of communication resources and technologies to enhance patient care and medical knowledge" "4.3 Use communication skills and strategies that help patients and their families make informed decisions regarding their health" "Describe elements of informed consent" "Demonstrate steps to obtaining informed consent" "Answer questions from the patient and family about next steps" "Use communication skills and strategies that help the patient and family make informed decisions regarding their health" "5 Document and share written and electronic information about the medical encounter to optimize clinical decision-making, patient safety, confidentiality, and privacy" "5.1 Document clinical encounters in an accurate, complete, timely, and accessible manner, in compliance with regulatory and legal requirements" "Describe the functions and principal components of a medical record Describe the regulatory and legal requirements, including privacy legislation, for record keeping Identify potential difficulties and errors in medical record keeping that have a negative impact on patient care or patient safety Document the essential elements of a clinical encounter using a structured approach Include as appropriate in the medical record the patient’s narrative* of the illness experience" "Organize information in appropriate sections within an electronic or written medical record Maintain accurate and up-to-date problem lists and medication lists" "Document information about patients and their medical conditions in a manner that enhances intra-and interprofessinal care Document clinical encounters to adequately convey clinical reasoning and the rationale for decisions" "Adapt record keeping to the specific guidelines of their discipline and the clinical context Identify and correct vague or ambiguous documentation" "Document clinical encounters in an accurate, complete, timely and accessible manner, and in compliance with legal and privacy requirements" "Teach or conduct peer review and practice assessment regarding record keeping practices Use medical record review to assess trainee clinical reasoning and their understanding of their patients as persons" "5.2 Communicate effectively using a written health record, electronic medical record, or other digital technology" "Demonstrate reflective listening, open-ended inquiry, empathy, and effective eye contact while using a written or electronic medical record" "Adapt use of the health record to the patient’s health literacy and the clinical context" "Communicate effectively using a written health record, electronic medical record, or other digital technology" "Teach others how to effectively communicate with patients while using a medical record Build reminders and clinical practice guidelines into the health record to enhance care" "5.3 Share information with patients and others in a manner that respects patient privacy and confidentiality and enhances understanding" "Describe the principles and legal requirements for privacy and confidentiality of written and electronic communication Describe the different levels of written and electronic health literacy of patients and their implications for patient care Describe the advantages, limitations and risks of using electronic communication directly with patients (including telehealth) and strategies to reduce these risks" "Assess patients’ needs and preferences with respect to methods of information sharing" "Adapt written and electronic communication to the specificity of the discipline and to the expectations of patients" "Share information with patients and others in a manner that respects patient privacy and confidentiality and enhances understanding" "Teach others, including patients, how to use electronic communication effectively and safely to protect confidentiality"