Learning Outcomes

Programme Learning Outcomes

set out in the 6 domains of ACGM-I, the definition of which follows each heading

Professionalism.
Patient Care and Procedural Skills
Medical Knowledge
Practice-based Learning and Improvement
Interpersonal and Communication Skills
Systems-based Practice

Here you see the Programme Level Learning outcomes mapped to those domains, expressed as behavioural descriptors of the graduate

1.Professionalism

Graduates must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles

Behaves at all times in accordance with their legal and ethical responsibilities
Understands the theory and practice of managing ethical dilemmas in clinical situations
Provides compassionate treatment of patients, respecting their privacy and dignity
Demonstrates understanding of patient capacity, consent and confidentiality in delivering medical care
Identifies and safeguards vulnerable patients
Demonstrates honesty, integrity, accountability and responsibility in all interactions with patients and their families, colleagues, and other health care workers
Advocates the interests of patients over their own, showing respect for racial, cultural, and religious differences
Takes prompt action on any issue of safety or quality of patient care, raising and escalating concerns where necessary

2.Patient Care and Procedural Skills

Graduates must provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health

Takes a relevant accurate history about the patient and their problems, to include physical, psychological, social and cultural elements. Interpreters or family members may be included in this history taking
Performs general and system-specific physical and mental health examination, identifying any abnormal or unexpected findings
Uses clinical judgement and critical appraisal skills to make informed, cost-effective decisions about ordering evidence based diagnostic and therapeutic interventions
Uses clinical reasoning to develop an appropriate differential diagnosis and identify related problems
Generates and initiates appropriate management plan for the patient in the context of the multidisciplinary team
Demonstrates awareness of the factors that predispose individuals to disease or injury
Demonstrates an understanding of basic human factors principles and practice at individual, team, organisational and system levels and how these may impact patient care
Applies understanding of preventative medicine, including patient education, to promote good health for all individuals
Recognizes immediately life-threatening conditions and institutes appropriate initial therapy including effective Basic Life Support
Demonstrates competence in a defined range of clinical skills unsupervised and to a predetermined standard
Deals appropriately with complexity and uncertainty including managing multimorbidity and prioritising tasks

3.Medical Knowledge

Graduates must demonstrate knowledge of established and evolving biomedical clinical, epidemiological, and social-behavioural sciences, as well at the application of this knowledge to patient care

Demonstrates an understanding of the normal structure and function of the individual that are important in maintaining homeostasis, and the alterations to these that result from age or pathology
Demonstrates an understanding of the pathophysiology, symptomology, investigation and treatment of specific diseases
Understands the science and interpretation of common diagnostic and therapeutic procedures
Understands the physical, psychological, cultural and social factors that may influence the maintenance of health, the presentation and course of illness, and the outcomes of treatment
Proposes individualised interventions to improve patients’ health related behaviour
Accommodates patient choice, empowering patients so as to increase self-help and improve concordance
Evaluates psychological and social factors influencing own behaviour and that of colleagues in medical settings

4.Practice-based Learning and Improvement

Graduates must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self- evaluation and lifelong learning

Understands the principles and use of evidence-based medicine, demonstrating this in the care of individuals and populations
Understands the principles and practice of formulating and investigating an answerable health care question as applied to a patient or population
Able to collect, assimilate and critically appraise information, (e.g. scientific papers, data) relevant to the care of individuals and populations

Understands practice-based learning and quality improvement techniques. This includes routine self-evaluation and appraisal of current best practice, with consequent improvements in patient care provision
Demonstrates the habit of life-long learning, making changes to own practice in response to learning opportunities

5.Interpersonal and Communication Skills

Graduates must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals

Demonstrates the ability to build rapport and show empathy to communicate compassionately, effectively, and in culturally and emotionally appropriate ways, with patients, their families, colleagues and others involved in the care of their patients
Demonstrates the ability to establish effective therapeutic relationships with patients and their families to provide reassurance, instil trust and maximise health outcomes
Demonstrates effective teamworking and leadership skills including reliability, punctuality collegiality, adaptability, trustworthiness and responsibility
Works collaboratively and effectively within multidisciplinary teams, sometimes across different settings, to provide safe and holistic health care to patients
Creates and maintains accurate, timely and legible medical records, and accurately presents findings to other healthcare professionals, communicating effectively in all media
Handles patient-identifiable information in a confidential manner

6.Systems-based Practice

Graduates must demonstrate an awareness of and responsiveness to the larger context and system of health care, including the social determinates of health, as well as the ability to call effectively on other resources in the system to provide optimal patient care

Recognises the wider determinants of health including economic, psychological, social, religious, historical, and cultural factors and how these contribute to health inequalities, both within Myanmar and globally
Demonstrates an understanding of the impact of health inequalities at the population and individual level, and supports the reduction of health disparity, especially as related to minority group individuals and underserved populations
Demonstrates an understanding of the use of epidemiological principles in assessing the health of the population and their applications to priority setting, resource allocation and service evaluation
Understands the principles of how to build teams and maintain effective team work to optimise patient care
identifies, and responds to, basic human factors principles and practice at individual, team, organisational and system levels and how these may impact patient care
Understands the settings, and inter-relationships of different health care settings and the importance of integrating patients’ care across them to ensure person-centred care
Understands health care financing, priority setting of resources and service evaluation
Demonstrates an understanding of the opportunities and threats to health care provision posed by potential conflicts of interest

Myanmar Curriculum Learning Outcomes 2021

Vertical Modules Learning Outcomes

Ethics and Professionalism
Clinical Management and Observation
Research and Medical Education
Social and Behavioural Science
Community Health
Family Medicine

Here you see the Module Level Learning outcomes mapped to those domains, expressed as behavioural descriptors of the graduate

i. Ethics and Professionalism:

The graduating doctor should demonstrate high ethical standards and professionalism, providing holistic patient care that is safe, appropriate, effective and compassionate. Specifically, the graduate:

Behaves at all times in accordance with their legal and ethical responsibilities
Understands the theory and practice of managing ethical dilemmas in clinical situations
Provides compassionate treatment of patients, respecting their privacy and dignity
Demonstrates understanding of patient capacity, consent and confidentiality in delivering medical care
Identifies and safeguards vulnerable patients
Demonstrates honesty, integrity, accountability and responsibility in all interactions with patients and their families, colleagues, and other health care workers
Advocates the interests of patients over their own, showing respect for racial, cultural, and religious differences
Takes prompt action on any issue of safety or quality of patient care, raising and escalating concerns where necessary
Uses self-evaluation to recognize and accept limitations in own knowledge and skills, seeking timely and appropriate support
Works effectively, respectfully and supportively as a member of the team: adapts behaviour to improve outcomes
Demonstrates respect for own health and the health of colleagues. Understands the effects of personal behaviour on practice
Recognises where conflicts of interest may occur in the doctor-patient relationship and takes appropriate steps to ensure patient care is not impacted

ii. Clinical management and observation:

The graduating doctor should be able to integrate the knowledge of pathophysiology, clinical and non-clinical skills they have learnt throughout the course to effectively, safely and compassionately assess and initiate management for the symptomatic presenting patient. Specifically, the graduate:

Demonstrates an understanding of the normal structure and function of the individual that are important in maintaining homeostasis, and the alterations to these that result from age or pathology
Demonstrates an understanding of the pathophysiology, symptomology, investigation and treatment of specific diseases (Appendix 2/ Excel spreadsheet)
Efficiently gathers information from the patient, relatives and others by means of a medical history
Undertakes physical examination and elicits normal and abnormal findings
Makes informed, cost-effective decisions when ordering evidence based diagnostic tests, and interprets results in the context of the individual patient
Uses clinical reasoning to develop an appropriate differential diagnosis and identify related problems
Generates and initiates appropriate management plan for the patient in the context of the multidisciplinary team

Creates and maintains accurate, timely and legible medical records, and accurately presents findings to other healthcare professionals, communicating effectively in all media
Handles patient-identifiable information in a confidential manner

Prescribes medicines safely, economically and effectively, and is able to communicate important side effects and adverse events clearly to patients
Demonstrates competence in a range of clinical skills (Appendix 3) unsupervised and to a predetermined standard
Demonstrates an understanding of basic human factors principles and practice at individual, team, organisational and system levels and how these may impact patient care
Recognises complexity and uncertainty and appropriately manages risk in clinical practice

iii. Research and Medical Education:

The graduating doctor should use their knowledge of, and skills in, research methods and medical education to improve outcomes for patients. Specifically, the graduate:

Demonstrates an understanding of how research, audit, quality improvement and continuing professional development contribute to better outcomes for patients
Demonstrates the ability to formulate an appropriate research question, choose an appropriate study design including data collection and analysis taking account of ethical issues
Demonstrates an understanding of how to search for evidence
Demonstrates an understanding of the grading of research evidence and critically appraise a research report
Uses clinical judgement and critical appraisal skills when making informed, cost-effective decisions about ordering evidence based diagnostic and therapeutic interventions
Demonstrates an ability to communicate research information clearly in written and spoken formats for varied audiences
Understands practice-based learning and quality improvement techniques. This includes routine self-evaluation and appraisal of current best practice, with consequent improvements in patient care provision
Effectively and appropriately provides teaching and mentorship for other learners in the multidisciplinary team including educational theories and assessment methods to match expected learning outcomes
Demonstrates the habit of life-long learning, making changes to own practice in response to evidence from own practice and research
Participates in the choice of suitable topics and methods of quality improvement including the use of audit period suggests changes to improve practice with the patient at the centre
Collect patient and colleague feedback and reflect on this as a learning opportunity

iv. Social and Behavioural Science:

The graduating doctor will be able to apply their understanding of psychological, social and cultural factors to provide effective and appropriate and sensitive healthcare for a diverse population. Specifically, the graduate:

Demonstrates an understanding of normal physical, psychological and social development through the lifespan and appreciates how this may be impacted by illness. Demonstrates an appreciation of how life stage may impact on doctor-patient relationship and adapts consultation style accordingly
Understands the physical, psychological, cultural and social factors that may influence the maintenance of health, the presentation and course of illness, and the outcomes of treatment
Demonstrates respect for patients’ health beliefs and ways of coping with illness, especially in regards to cultural and religious influences
Demonstrates an understanding of theories of health behaviour change, conditioning and personality, and the role of social support, motivation and self-efficacy in behaviour change. Applies this knowledge to design individualised health improvement plans
Weighs quantitative information such as risk, likelihood of beneficial and adverse outcomes, life expectancy, as well as qualitative factors, such as individual patients’ values and preferences and accommodates patient choice in management plans to help improve treatment concordance and compliance
Demonstrates an understanding of the context of their work in a complex social system comprising the patient, their relatives, the healthcare team and support organisations
Demonstrates an understanding of the principles of how to build teams and maintain effective team work and applies this to clinical practice

v. Community Health:

The graduating doctor demonstrates an understanding of public health theory and can apply this to their clinical practice. Specifically, the graduate:

Recognises the wider determinants of health including health including economic, psychological, social, religious, historical, and cultural factors and how these contribute to health inequalities, both within Myanmar and globally
Demonstrates an understanding of the impact of health inequalities at the population and individual level, and supports the reduction of health disparity, especially as related to minority group individuals and underserved populations
Demonstrates an understanding of the use of epidemiological principles in assessing the health of the population and their applications to priority setting, resource allocation and service evaluation
Relates epidemiology and public health theory to the needs of communities in order support the reduction in incidence, prevalence and impact of ill health
Demonstrates an understanding of epidemiological study design and basic statistical concepts
Demonstrates an understanding of the services involved in promoting wellbeing, preventing illness, and protecting the health of the population
Demonstrates an understanding of strategies for primary, secondary and tertiary disease prevention
Demonstrates an understanding of the principles of screening for disease and pre-disease states
Demonstrates an understanding of the basic principles of health protection including disease surveillance, control of communicable and non-communicable diseases and emergency planning

vi. Family Medicine:

The graduating doctor is able to integrate the knowledge, skills and behaviours learned throughout the course and apply them in a clinical setting as appropriate for patients presenting with undifferentiated symptoms to ensure safe, compassionate and effective primary care. Specifically, the graduate:

Appropriately assesses the patient presenting with undifferentiated symptoms to make a safe differential diagnosis and institute appropriate management in a community setting
Differentiates between those who can be safely managed in the community and those who need specialist referral
Works to integrate patients’ care across different settings and disciplines to ensure person-centred care
Provides holistic care to patients based on a mutual understanding of their physical, psychological, emotional, and spiritual dimensions
Demonstrates the ability to build rapport and show empathy to communicate compassionately, effectively, and in culturally and emotionally appropriate ways, with patients, their families, colleagues and others involved in the care of their patients
Effectively manages the ‘difficult’ consultation including defusing aggression, breaking bad news and admitting lack of knowledge or mistakes
Demonstrates the ability to establish effective therapeutic relationships with patients and their families to provide reassurance, instil trust and maximise health outcomes
Applies understanding of preventative medicine in the community, including patient education, to promote good health for all individuals
Demonstrates proficiency in the identification and management of long term conditions in primary care according to relevant guidelines
Recognises risks and clinician responsibilities in remote consultations (e.g. telephone triage, video consultations) and institutes appropriate safeguards