What is doc.com

							And how can it help prepare our residents for practice?

                       Marie-Therese Cave. M.Sc. P.G. Dip Couns. Cert.Ed
                                    Faculty Development . April 19th 2011
Objectives
 To introduce doc.com and reasons for implementation
 To familiarise participants with doc.com and to gain
  feedback from established family medicine educators
 To consider application in office setting
 To discuss residents’ response to implementation
Timeline for session
 Introduction to doc.com          20 minutes
 Initial Questions                10 minutes
 Hands on experience of doc.com   60 minutes
 Plenary discussion-what next?    30 minutes
Introduction to doc.com
Overview
 Web based modular course in health care
  communication addressing communication between:
 HCP- Patient
 HCP- Patient’sFamily
 HCP- HCP
 HCP Teams
Characteristics of doc.com’s
pedagogical approach
 Evidence based approach to physician/patient
  communication
 Modular
 Web based- anytime access
 Created by international group of medical educators
  including:
  Julian Tudor Hart, Cathy Cole Kelly, Cathy Risden, Ron
  Epstein, Elizabeth Gaufberg
Reasons for implementation in
our curriculum
 Move to Triple C Curriculum
 Centered in Family Medicine, Continuity, Comprehensive


 Physical and Logistical Changes
 3 blocks of Fam Med blocktime to 2 blocks = more residents in FM blocktime
 and for longer


 Increase in Community Physician Faculty Advisors
 with responsibility for PGY1 residents.
 (largely unaware of Behav med curriculum, content and process)
How doc.com is being used in
the curriculum
 1st year. Basic Modules are a revision for most residents.
  Helps us identify residents who need more help.
 2nd year. Advanced modules
 Faculty Development.
Challenges @ Introduction
 Introduced at same time as CBAS
 Required to be in place before accreditation
 Lack of Faculty Development
 Leave of Absence in place for Course Coordinator
Modules currently being used
 Mindfulness
 Opening the discussion
 Gathering information
 Understanding patient’s perspective
 Sharing the information
 Reaching agreement.
 Breaking Bad news.
Residents’ response to doc.com
curriculum
 “We did this in undergrad.”
 “It is too theoretical”
 “Too long”
 “Too directive”
 “Not realistic”
Facts
 Undergraduate learning. PCCM. 1st and 2yr year of
  medical school. 3rd and 4th year clerks chart using
  traditional medical inquiry format.
 Skills need Practice. Comparison with ACLS
  Communication consultation skills used many more
  times than any other clinical skill.
 Faculty some unaware of current CCFP standards.
 Residents fail. Unaware of importance of context in
  Diagnosis and Management plan.
Discussion/ Questions
Plenary Discussion
Personal experience of doc.com
What we like.
What we dislike
Is any of it useful to faculty advisors?

Context for Learning
How could doc.com be helpful in clinic?