Medical Consultation Model consult

1
Medical Consultation (Model consult)
Medical Knowledge Competencies (human art)
2
CanMEDS 2000 model Algemeen versus vakspecifiek
Algemeen
vakspecifiek
Medisch handelen
medical expert
Communicatie
communicator
Samenwerking
collaborator
Organisatie
manager
Bevorderen van gezondheid
health advocate
Kennis en wetenschap
scholar
Professionaliteit
professional
3
Classic Diagnostic process
Take a history Develop hypotheses Perform a
physical examination Generate a differential
diagnoses Test the Hypotheses Modify your
differential diagnosis
The Plan ?Context
4
A clinical Instrument for biopsychosocial
assessment
IDIS
De Jonge, Huyse, Stiefel, Slaets, Gans.
Psychosomatics 2001
5
Medical Consultation
History taking open questions Generate
problem list and first dd Relevant medical
history somatic and psychological Hypotheses-dri
ven questions Adjust problem list and dd Social
history/Health Care system Medication/Diet/Allergi
es/Substance abuse Family History Determine
Actual Context (Frailty-indicators)
IDIS Somatic, Psychological, Social, Health Care
Adjust problem list and dd Review of the
systems Adjust problem list and dd
6
Physical Exam Adjust problem list and
dd Summary Final problem list and differential
diagnosis Decide on a working diagnosis Describe
Actual context (prognosis) Diagnostic and
Therapeutic plan
7
G2010
Year 1 Patient demonstration IDIS system Year 2
and Year 3 increase clinical knowledge Year 4
Mastery of Medical Consult Mastery of
Discipline-specific consultation e.g.
neurology Learn how to leave things out (but not
the IDIS) Year 5 integration of medical
competencies Year 6 schakeljaar