Table 1 Competency-based Learning Objectives Utilizing a CanMEDS Framework, with selected examples of specific competencies. Overarching philosophy of care: patient-centred care for this complex population (those diagnosed with HIV, mental illness, and other forms of psychosocial complexity) is achieved through representation of diverse perspectives – from patients and invested care providers – and through collaboration formalized through shared learning and work opportunities
From: Preparing future physicians for complexity: a post-graduate elective in HIV psychiatry
Competency Domain | Specific Competencies | CanMEDS competencies |
|---|---|---|
Comprehensive understanding of complexity for individuals with triple diagnosis | Recognize how syndemics of triple diagnosis amplify comorbidities and negatively affect health outcomes. | - Medical expert - Health advocate - Communicator |
Integrated medical and neuropsychiatric assessment and management of patients | Conduct comprehensive psychiatric assessment of individuals with triple diagnosis, including evaluation of common neuropsychiatric findings (i.e., basic neurological exam, cognitive screening), gathering collateral information, and be able to recognize indication for further investigations (i.e., labs, imaging, formal neurocognitive testing). | - Medical expert - Communicator |
Psychotherapeutic skills as a means for engagement and traversing barriers to health for this complex population | Demonstrate an appreciation of patient lived experience, and a non-judgmental approach to eliciting patient narrative through clinical interview, recognizing the impact of trauma and stigma on assessment process. Support patient’s active role in treatment and empower patient’s knowledge of their own strengths and challenges to guide therapeutic course. | - Communicator - Health advocate - Scholar |
Navigation of systems of care across community and hospital systems, including interdisciplinary models of care for individuals with triple diagnosis | Recognize patient’s experiences of disjointed systems of care, limited mental health resources, and the interaction between the above and other social determinants of health acting as barriers to care. | - Health advocate - Leader |