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Table 2 'Initiating medication' EPA and the CanMEDS roles.

From: Using entrustable professional activities to guide curriculum development in psychiatry training

  

Indicative questions

Medical expert

The trainee demonstrates the ability to make an accurate diagnosis, has conducted the appropriate assessments, can describe the evidence for the use of the medication, its dosage, interactions and side effects.

Has an appropriate diagnostic assessment been completed?

  

Is the use of this medication evidence-based?

  

Are there any contraindications to the use of this medication (significant interactions etc)?

  

Is the dosing regime correct?

  

Have appropriate investigations been performed?

  

What plan is there to assess outcome?

Communicator

The trainee shows the ability to explain to the patient the benefits and risks of the medication and how it should be taken and addresses the patients questions.

Have the reasons for the use of this medication been explained so that the patient is able to understand?

  

Have the benefits of the medication been explained?

  

Have the risks (major side effects) of the medication been explained?

  

Has the patient been explained about what to do should side effects emerge?

  

Has the dosing regime been explained so that the patient understands?

  

Has the need for further investigations been explained?

  

Have the patient's questions been responded to appropriately?

Collaborator

The trainee ensures that members of the MDT (and GP) are aware of how the medication fits in with the management plan

Has information about the medication been communicated with the MDT?

  

Has information about the medication been communicated with significant others?

  

Has the GP been informed?

Professional

The trainee has obtained informed consent

Has informed consent been obtained?

  

Are there any conflicts of interest?

Scholar

The trainee is able to apply the evidence from clinical practice guidelines

What is the evidence base for the medication?

  

What process will be used to evaluate outcome?

  

Can the trainee explain the mechanism of action?

Health advocate

The trainee ensures that the patient is able to access the medication

Has there been a check on whether the patient can access the medication?

  

Has there been a check on whether the patient can afford the medication?

  

Has the appropriate authority form been used?

Manager

Clear and accurate documentation is completed

Is the documentation in the case note clear and accurate?

  

Has the medication form (prescription) been completed correctly?

  

Has the use of health resources been considered?

  1. Initiating medication requires a demonstration of competencies across all the CanMEDS roles. The assessment of the trainee's performance should be conducted in a real life clinical situation under the observation of the supervisor.
  2. Prior to the clinical encounter the trainee should explain to the supervisor the rationale for using this medication, for this patient at this time. This will allow for an assessment of the trainee's knowledge base for the use of this treatment modality.
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BMC Medical Education

ISSN: 1472-6920

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