Dermatology

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Type of observation

1. ●direct
2. ●case review

Medical Expert

• □ME 2.2 Elicit an accurate, relevant history
• □ME 2.2 Perform a physical examination that informs the diagnosis
• □ME 2.1 Determine the acuity of the condition
• □ME 2.2 Synthesize and organize clinical information for clear and succinct presentation to a supervisor

Communicator

• □COM 1.2 Optimize the physical environment for patient comfort, dignity and privacy
• □COM 2.3 Identify other sources of information (e.g. family, medical record) that may assist in the patient’s care
• □COM 5.1 Document the clinical encounter using a structured approach

Professional

• □P 1.1 Behave in a professional manner

Case description

Feedback provided

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Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Demographic

1. ●adult
2. ●pediatric

Skin of colour

1. ●no
2. ●yes

Affected area

1. ●skin
2. ●hair
3. ●nail
4. ●mucosa

Morphology

1. ●macule/patch
2. ●papule/plaque
3. ●vesicle/bulla
4. ●nodule
5. ●other

Medical Expert

• □ME 2.2 Perform a physical examination relevant to the presentation
• □ME 2.2 Use special examination techniques, as relevant
• □ME 2.2 Describe the morphology of the lesion(s), using appropriate terminology
• □ME 2.2 Classify the lesion(s) based on morphology
• □ME 2.2 Develop a differential diagnosis
• □ME 2.2 Propose a most likely diagnosis for common disorders

Case description

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Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Biopsy

1. ●punch
2. ●shave
3. ●other

Medical Expert

• □ME 3.2 Obtain and document informed consent, explaining the risks and rationale for the biopsy
• □ME 3.1 Select the appropriate biopsy site, technique, and sample medium
• □ME 3.4 Demonstrate clean technique, establish and respect the sterile field, and maintain universal precautions
• □ME 3.4 Perform the procedure in a skilful and safe manner
• □ME 3.4 Complete the pathology requisition accurately and completely
• □ME 3.4 Establish and implement a plan for post-procedure care

Communicator

• □COM 3.1 Communicate effectively with the patient during the procedure

Case description

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Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Demographic

1. ●adult
2. ●pediatric

Settings

1. ●emergency department
2. ●inpatient
3. ●outpatient

Medical Expert

• □ME 2.1 Determine the acuity of the situation and the priorities for patient care
• □ME 2.2 Provide assessment and initial stabilization of ABCs
• □ME 2.2 Perform a history and physical examination relevant to the patient presentation, in a time-effective manner
• □ME 2.2 Select and/or interpret investigations
• □ME 2.4 Develop and implement a plan for initial management
• □ME 4.1 Determine the appropriate disposition and/or setting for ongoing care

Collaborator

• □COL 1.3 Work effectively with other members of the health care team

Professional

• □P 1.1 Work within personal limits, asking for assistance as needed

Case description

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Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Observation

1. ●direct
2. ●case review

Demographic

1. ●adult
2. ●pediatric

Type of condition

1. ●allergic/immunologic
2. ●cardiac
3. ●endocrine
4. ●GI
5. ●hematologic
6. ●neurologic
7. ●renal
8. ●respiratory
9. ●other

Medical Expert

• □ME 2.2 Gather a relevant clinical history
• □ME 2.2 Perform a physical examination relevant to the presentation
• □ME 2.2 Select and/or interpret investigations
• □ME 2.2 Develop a differential diagnosis
• □ME 2.4 Develop a management plan
• □ME 2.2 Synthesize and organize clinical information for clear and succinct presentation to a supervisor

Communicator

• □COM 2.1 Use patient-centred interviewing skills, and inclusive and person-first language
• □COM 2.3 Seek and synthesize relevant information from other sources (e.g. family, medical record)

Collaborator

• □COL 1.2 Work effectively as a member of the clinical team

Case description

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Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Observation

1. ●direct
2. ●case review

Demographic

1. ●adult
2. ●pediatric

Type of condition

1. ●allergic/immunologic
2. ●cardiac
3. ●endocrine
4. ●GI
5. ●hematologic
6. ●neurologic
7. ●renal
8. ●respiratory
9. ●other

Medical Expert

• □ME 2.2 Gather a relevant clinical history
• □ME 2.2 Perform a physical examination relevant to the presentation
• □ME 2.2 Select and/or interpret investigations
• □ME 2.2 Assess the patient for response to therapy, complications, and/or status of their chronic condition
• □ME 2.4 Develop a management plan

Collaborator

• □COL 1.3 Integrate the patient’s and/or family’s perspective into the care plan

Health Advocate

• □HA 1.2 Work with the patient and/or family to increase their understanding of their illness and health care needs

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

MSK exam observed

1. ●no
2. ●yes

Case mix

1. ●inflammatory arthritis
2. ●non-inflammatory arthritis
3. ●connective tissue disease
4. ●vasculitis
5. ●other

Medical Expert

• □ME 2.2 Gather a relevant clinical history
• □ME 2.2 Elicit pertinent information from a review of systems
• □ME 2.2 Perform an MSK physical examination using appropriate technique for joint examinations
• □ME 2.2 Perform a physical examination for relevant extra-articular manifestations of rheumatologic disease
• □ME 2.2 Perform the physical examination in a manner that minimizes discomfort or distress
• □ME 2.2 Select and/or interpret investigations
• □ME 2.2 Develop a differential diagnosis
• □ME 2.4 Develop a management plan
• □ME 2.2 Synthesize and organize clinical information for clear and succinct presentation to a supervisor

Communicator

• □COM 2.1 Use patient-centred interviewing skills, and inclusive and person-first language

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Setting

1. ●clinic
2. ●ward
3. ●ICU

Skin findings

1. ●no
2. ●yes

Medical Expert

• □ME 2.2 Gather a relevant clinical history
• □ME 2.2 Perform a physical examination relevant to the presentation
• □ME 2.2 Select and/or interpret investigations
• □ME 2.2 Develop a differential diagnosis
• □ME 2.4 Develop a management plan
• □ME 2.2 Synthesize and organize clinical information for clear and succinct presentation to a supervisor

Communicator

• □COM 2.3 Seek and synthesize relevant information from other sources (e.g. family, medical record)

Professional

• □P 1.1 Maintain universal precautions

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Demographic

1. ●adult
2. ●pediatric

Experience

1. ●dermatology
2. ●emergency medicine
3. ●infectious disease
4. ●internal medicine
5. ●pediatrics
6. ●rheumatology
7. ●other

Type of documentation

1. ●consult report
2. ●progress note
3. ●clinic note
4. ●discharge letter
5. ●admission note
6. ●other (write in)

Medical Expert

• □ME 2.2 Synthesize and interpret information from the clinical assessment

Communicator

• □COM 5.1 Organize information in appropriate sections
• □COM 5.1 Document all relevant findings and investigations
• □COM 5.1 Convey clinical reasoning and the rationale for decisions
• □COM 5.1 Provide a clear plan for ongoing management
• □COM 5.1 Complete clinical documentation in a timely manner

Case description

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Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Patient demographic

1. ●pediatric
2. ●adult

Setting

1. ●inpatient
2. ●outpatient

Communicator

• □COM 1.1 Establish rapport with the patient and/or family
• □COM 1.6 Tailor the approach to communication to the needs of the patient and/or family
• □COM 1.1 Engage the patient in the discussion as appropriate for their developmental stage
• □COM 3.1 Provide accurate information about medical condition and management plan
• □COM 3.1 Use plain language and avoid medical jargon
• □COM 4.3 Solicit and answer questions from the patient and/or family
• □COM 3.1 Verify and validate the patient and/or family’s understanding
• □COM 4.2 Use communication skills and strategies that help the patient and/or family make informed decisions
• □COM 4.1 Communicate in a manner that is respectful, non-judgmental and culturally aware

Case description

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Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Experience

1. ●dermatology
2. ●emergency medicine
3. ●infectious disease
4. ●internal medicine
5. ●pediatrics
6. ●rheumatology
7. ●other

Includes input from

1. ●other supervisor(s)
2. ●nurse(s)
3. ●other physician(s)
4. ●other health care professional(s)
5. ●resident(s) or student(s)
6. ●other

Collaborator

• □COL 1.2 Demonstrate an understanding of the scope and expertise of other health care professionals
• □COL 1.3 Communicate effectively with physicians and other health care professionals
• □COL 1.1 Respond appropriately to input from other health care professionals
• □COL 1.1 Accept feedback in the spirit of cooperation and learning

Professional

• □P 1.1 Demonstrate punctuality
• □P 1.1 Complete assigned responsibilities
• □P 1.1 Behave in a professional manner
• □P 1.1 Respond punctually to requests from patients or other health care professionals

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Demographic

1. ●adult
2. ●pediatrics

Setting

1. ●clinic
2. ●emergency department
3. ●ward
4. ●ICU

Medical Expert

• □ME 2.1 Determine the acuity of the situation and the priorities for patient care
• □ME 1.5 Perform a clinical assessment that addresses all relevant issues
• □ME 2.2 Select and/or interpret investigations
• □ME 2.2 Integrate the clinical data to establish the diagnosis and severity of the condition
• □ME 2.4 Determine the appropriate setting for ongoing care
• □ME 2.4 Develop a management plan
• □ME 4.1 Determine if there is a need for consultation with another specialist or service

Collaborator

• □COL 1.2 Work effectively with members of the interprofessional team to implement a management plan

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Type of observation

1. ●direct
2. ●case review

Demographic

1. ●adult
2. ●pediatric

Skin of colour

1. ●no
2. ●yes

Complex case

1. ●no
2. ●yes

Category

1. ●infection/infestation
2. ●inflammatory/immunologic
3. ●neoplasm, proliferation or cyst
4. ●genetic/developmental
5. ●iatrogenic, including adverse drug reaction
6. ●occupational/provoked by external factors
7. ●metabolic/nutritional
8. ●sensory/psychological
9. ●hair, nail, mucous membrane and/or appendage
10. ●disorder in pregnancy/neonatal period

Medical Expert

• □ME 2.1 Determine the acuity of the situation and the priorities for patient care
• □ME 1.5 Perform a clinical assessment that addresses all relevant issues
• □ME 2.2 Formulate a differential and most likely diagnosis
• □ME 2.2 Select, prioritize and/or interpret investigations
• □ME 2.4 Develop a management plan
• □ME 4.1 Develop a plan for follow-up on investigations and monitor response to treatment

Communicator

• □COM 3.1 Provide information to the patient about the diagnosis and management plan

Collaborator

• □COL 1.3 Communicate effectively with the consulting service

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Demographic

1. ●adult
2. ●pediatric

Skin of colour

1. ●no
2. ●yes

Complex case

1. ●no
2. ●yes

Category

1. ●infection/infestation
2. ●inflammatory/immunologic
3. ●neoplasm, proliferation or cyst
4. ●genetic/developmental
5. ●iatrogenic, including adverse drug reaction
6. ●occupational/provoked by external factors
7. ●metabolic/nutritional
8. ●sensory/psychological
9. ●hair, nail, mucous membrane and/or appendage
10. ●disorder in pregnancy/neonatal period

Medical Expert

• □ME 2.2 Gather a history and perform a physical examination relevant to the presentation
• □ME 2.2 Formulate a differential and most likely diagnosis
• □ME 2.2 Select, prioritize and/or interpret investigations
• □ME 2.4 Develop a management plan

Communicator

• □COM 3.1 Provide information to the patient about the diagnosis and management plan
• □COM 5.1 Write prescriptions clearly, with attention to atypical dosing and frequency

Health Advocate

• □HA 1.2 Provide education resources and facilitate services for the patient and/or family

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Demographic

1. ●adult
2. ●pediatric

Skin of colour

1. ●no
2. ●yes

Complex case

1. ●no
2. ●yes

Category

1. ●infection/infestation
2. ●inflammatory/immunologic
3. ●neoplasm, proliferation or cyst
4. ●genetic/developmental
5. ●iatrogenic, including adverse drug reaction
6. ●occupational/provoked by external factors
7. ●metabolic/nutritional
8. ●sensory/psychological
9. ●hair, nail, mucous membrane and/or appendage
10. ●disorder in pregnancy/neonatal period

Medical Expert

• □ME 2.2 Synthesize patient information to determine clinical status, response to treatment and/or toxicity
• □ME 2.2 Interpret the results of investigations performed to monitor the condition and/or treatment
• □ME 2.2 Assess adherence to treatment
• □ME 2.4 Develop a plan for management, which may include modification of current therapy
• □ME 4.1 Determine the frequency and timing of future investigations and visits

Communicator

• □COM 4.2 Facilitate self care and chronic disease management

Collaborator

• □COL 1.3 Integrate the patient’s and family’s perspective and context into the care plan
• □COL 3.1 Determine when care should be transferred back to a primary care provider

Leader

• □L 2.1 Consider costs and resource availability when selecting diagnostic or treatment options

Health Advocate

• □HA 1.3 Incorporate prevention, health promotion and health surveillance into the patient interaction

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Treatment

1. ●systemic corticosteroid
2. ●conventional immunomodulatory agent
3. ●targeted therapy
4. ●retinoid
5. ●antibacterial
6. ●antiviral
7. ●antifungal
8. ●phototherapy
9. ●other

Medical Expert

• □ME 2.2 Assess the patient’s health status, including the status of their dermatologic condition and any concurrent illnesses
• □ME 1.3 Apply knowledge of systemic therapy, including pharmacology, potential adverse events and their prevention/management
• □ME 2.4 Select an appropriate treatment and regimen
• □ME 3.2 Provide information to the patient about the indications, contraindications, risks, and alternatives for a given treatment plan
• □ME 3.2 Use shared decision-making in the consent process
• □ME 2.4 Implement any required adjustments in dosing or regimen based on the patient's health status or concurrent illnesses
• □ME 2.4 Select and prescribe supportive care to mitigate adverse effects
• □ME 2.4 Implement monitoring strategies

Health Advocate

• □HA 1.1 Facilitate patient’s access to needed medications

Scholar

• □S 3.4 Integrate best evidence and clinical expertise into decision-making

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Type of wound

1. ●traumatic
2. ●inflammatory
3. ●neuropathic
4. ●decubitus
5. ●venous
6. ●arterial
7. ●mixed
8. ●other

Management

1. ●dressing
2. ●compression
3. ●surgical

Medical Expert

• □ME 2.2 Gather a history and perform a physical examination relevant to the presentation
• □ME 2.2 Identify patient factors that predispose to poor wound healing
• □ME 2.2 Select and/or interpret investigations
• □ME 2.4 Develop a management plan
• □ME 2.4 Provide wound care, including appropriate dressings, antimicrobials and/or wound care systems as needed
• □ME 4.1 Determine whether there is a need to refer for surgical intervention
• □ME 4.1 Establish a plan for ongoing care and/or follow-up of results of investigations

Health Advocate

• □HA 1.1 Work with the patient to address lifestyle factors that impact their health

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Presentation

1. ●basal cell carcinoma
2. ●invasive melanoma
3. ●non-invasive melanoma
4. ●squamous cell carcinoma
5. ●other skin cancer

Management

1. ●active non-intervention
2. ●topical
3. ●electrodesiccation and curettage
4. ●wide local excision
5. ●Mohs
6. ●sentinel lymph node biopsy
7. ●radiation
8. ●other

Medical Expert

• □ME 2.2 Interpret the results of investigations done for diagnosis and/or staging (pathology, imaging, tumour markers)
• □ME 2.2 Identify features of the patient’s condition or co-morbidities which modify the risk of disease progression and/or treatment
• □ME 4.1 Determine the need and timing of referral to another physician or surgeon
• □ME 2.4 Develop and implement a plan, which may include further investigation, surveillance, medical treatment and/or surgical intervention
• □ME 3.1 Provide information about the proposed management plan, including the risks, benefits and potential alternative treatments

Communicator

• □COM 3.1 Provide information on diagnosis and prognosis clearly and compassionately
• □COM 4.2 Use communication skills and strategies that help the patient and/or family make informed decisions

Scholar

• □S 3.4 Integrate best evidence and clinical expertise into decision-making

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Patient demographic

1. ●pediatric
2. ●adult

Skin of colour

1. ●no
2. ●yes

Assessment of

1. ●pigmented lesion
2. ●keratinocyte carcinoma
3. ●nail
4. ●hair
5. ●other

Medical Expert

• □ME 2.2 Utilize non-contact, contact, polarized, or non-polarized technique as appropriate
• □ME 2.2 Perform a dermoscopic assessment and identify key features of the lesion
• □ME 1.3 Apply knowledge of the dermoscopic features of skin disorders to classify the lesion
• □ME 2.2 Determine the diagnosis
• □ME 2.2 Ensure instrument is cleaned between patients

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Skin of colour

1. ●no
2. ●yes

Patch test application/removal

1. ●no
2. ●yes

Occupational counselling

1. ●no
2. ●yes

Medical Expert

• □ME 2.2 Gather a history and perform a physical examination relevant to the presentation
• □ME 2.2 Identify potential exposures
• □ME 3.2 Describe the patch test procedure and explain the risks and benefits of, and the rationale for the procedure
• □ME 3.4 Select the appropriate series for patch testing based on potential exposures
• □ME 3.4 Assess the quality of the test and any impact on diagnostic interpretation
• □ME 2.2 Identify findings of clinical significance

Communicator

• □COM 3.1 Provide information to the patient regarding the implications of the findings

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Demographic

1. ●age <10
2. ●age 10–18
3. ●adult

Skin of colour

1. ●no
2. ●yes

Procedure

1. ●shave biopsy
2. ●punch biopsy
3. ●elliptical biopsy
4. ●wide local excision
5. ●intralesional injection: electrodesiccation and curettage
6. ●cryotherapy
7. ●other

Special site

1. ●no
2. ●yes

Medical Expert

• □ME 3.2 Obtain informed consent, explaining the risks, rationale, and alternatives to the proposed procedure
• □ME 3.4 Assemble/gather the appropriate equipment and materials
• □ME 3.4 Demonstrate clean technique, establish and respect the sterile field, and maintain universal precautions
• □ME 3.4 Select and provide local and/or regional anaesthesia, as relevant
• □ME 3.4 Perform the procedure in a skilful and safe manner
• □ME 3.4 Monitor patient comfort and safety, and adjust the procedure as needed
• □ME 3.4 Establish and implement a plan for post-procedure care

Communicator

• □COM 3.1 Communicate effectively with patient and/or assistant(s) during the procedure
• □COM 5.1 Document the procedure and outcome

Professional

• □P 1.1 Work within personal limits, asking for assistance as needed

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Procedure discussed

1. ●neurotoxin
2. ●soft tissue filler
3. ●chemical peel
4. ●laser and energy- based device

Skin of colour

1. ●no
2. ●yes

Setting

1. ●clinical
2. ●simulation

Medical Expert

• □Part A: ME 2.2 Gather a history and perform a physical examination relevant to the presentation
• □Part A: ME 2.2 Assess the psychological and social factors contributing to a request for an aesthetic/cosmetic procedure
• □Part A: ME 2.3 Ascertain and manage patient expectations
• □Part A: ME 3.1 Determine the appropriate procedure
• □Part A: ME 3.2 Obtain informed consent, explaining the risks, rationale, and alternatives to the proposed procedure
• □Part B: ME 3.4 Assemble/gather the appropriate equipment and materials
• □Part B: ME 3.1 Select the appropriate dosing, volumes, or settings for the procedure and the patient
• □Part B: ME 3.4 Demonstrate clean technique, establish and respect the sterile field, and maintain universal precautions
• □Part B: ME 3.4 Perform the procedure in a skilful and safe manner
• □Part B: ME 3.4 Monitor patient comfort and safety, and adjust the procedure as needed
• □Part B: ME 3.4 Establish and implement a plan for post-procedure care

Communicator

• □Part A: COM 1.1 Recognize and respect the patient’s psychological and emotional needs
• □Part A: COM 3.1 Use plain language and avoid medical jargon
• □Part A: COM 5.1 Document the discussion regarding informed consent in an accurate and complete manner
• □Part B: COM 3.1 Communicate effectively with patient and/or assistant(s) during the procedure
• □Part B: COM 5.1 Document the procedure and outcome

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Complication

1. ●medical
2. ●surgical

Demographic

1. ●adult
2. ●pediatric

Medical Expert

• □ME 1.5 Perform a clinical assessment that addresses all relevant issues
• □ME 2.2 Identify factors contributing to a complication of a dermatologic procedure and/or intervention
• □ME 2.2 Select and/or interpret investigations
• □ME 2.4 Develop a management plan
• □ME 4.1 Develop a plan to follow up on investigations and monitor response to treatment

Communicator

• □COM 3.2 Disclose an adverse event and/or outcome to the patient and/or family

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Demographic

1. ●adult
2. ●pediatric

Theme

1. ●disease/treatment education
2. ●disease prevention
3. ●health promotion

Medical Expert

• □ME 2.3 Address with the patient and/or family their ideas about the nature and cause of the condition, fears and concerns, and/or expectations of health care professionals

Communicator

• □COM 3.1 Provide information and explanations that are clear and accurate
• □COM 3.1 Use plain language and avoid medical jargon
• □COM 4.3 Solicit and answer questions from the patient and/or family

Health Advocate

• □HA 1.2 Work with the patient and/or family to increase their understanding of their illness and health care needs
• □HA 1.2 Provide education resources and facilitate services for the patient and/or family
• □HA 1.3 Implement strategies for disease prevention, health promotion and health surveillance
• □HA 1.1 Facilitate timely patient access to services and resources

Professional

• □P 1.1 Demonstrate respect for patient autonomy

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Scenario

1. ●patient/family
2. ●other health care professional(s)

Setting

1. ●clinical
2. ●simulation

Medical Expert

• □ME 2.1 Ascertain participants’ understanding of the situation and the reason for the encounter

Communicator

• □COM 1.1 Demonstrate empathy, respect and compassion
• □COM 3.1 Provide information and explanations that are clear and accurate
• □COM 3.1 Verify understanding of information conveyed
• □COM 1.4 Identify, verify and validate non-verbal cues
• □COM 2.2 Manage the flow of the encounter
• □COM 1.5 Recognize when strong emotions (such as anger, fear, anxiety, or sadness) are impacting an interaction and respond appropriately
• □COM 1.5 Establish boundaries as needed in emotionally charged situations
• □COM 2.2 Summarize and close the encounter effectively
• □COM 5.1 Document the encounter to convey the discussion and its outcome

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Communicator

• □COM 5.1 Document all relevant findings and investigations
• □COM 5.1 Convey clinical reasoning and the rationale for decisions
• □COM 5.1 Provide a clear plan for ongoing management
• □COM 5.1 Complete clinical documentation in a timely manner

Collaborator

• □COL 1.2 Identify the roles of the dermatologist and the referring physician in the ongoing management plan
• □COL 3.2 Provide anticipatory guidance for results of outstanding investigations and/or next steps for management

Scholar

• □S 1.3 Provide teaching points to improve quality of care

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Observation

1. ●direct
2. ●case review

Demographic

1. ●adult
2. ●pediatric

Visit

1. ●new
2. ●follow-up

Medical Expert

• □ME 2.2 Gather a relevant clinical history
• □ME 2.2 Perform a physical examination adapted to the virtual health environment
• □ME 2.2 Review photographs or images of the skin condition
• □ME 2.2 Select and/or interpret investigations
• □ME 2.2 Assess the quality of the clinical information gathered
• □ME 2.4 Determine if an in-person visit is required
• □ME 2.4 Develop a management plan

Communicator

• □COM 5.3 Use virtual health technology in a manner that respects patient privacy and confidentiality
• □COM 2.3 Seek and synthesize relevant information from other sources (e.g. family, medical record)
• □COM 3.1 Convey information to the patient related to any uncertainty in diagnosis and/or treatment
• □COM 5.2 Communicate effectively with the patient in the virtual health environment

Leader

• □L 2.1 Apply knowledge of the health care resources available in other care settings

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Diagnosis

1. ●inflammatory
2. ●infection
3. ●neoplastic
4. ●other

Medical Expert

• □ME 2.2 Assess the quality of the sample and any impact on the diagnostic interpretation
• □ME 1.3 Apply knowledge of dermatopathology and immunodermatopathology
• □ME 2.2 Identify salient features in the tissue sample
• □ME 3.1 Recognize when a specimen might require ancillary studies
• □ME 2.2 Select ancillary investigations and techniques such as special stains and polarized light
• □ME 2.2 Correlate findings with clinical information and results of other investigations
• □ME 2.2 Establish a diagnosis or differential diagnosis

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Teaching activity

1. ●formal
2. ●informal

Scholar

• □S 2.4 Identify the learning needs and desired learning outcomes of others
• □S 2.4 Develop learning objectives for a teaching activity
• □S 3.3 Critically evaluate the literature
• □S 3.4 Integrate best evidence and clinical expertise
• □S 2.2 Create a positive learning environment
• □S 2.4 Present the information in an organized manner to facilitate understanding
• □S 2.4 Use audiovisual aids effectively
• □S 2.4 Provide adequate time for questions and discussion
• □S 2.4 Facilitate learner engagement and participation

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Scholar

• □S 4.4 Generate focused questions for scholarly investigation
• □S 3.3 Critically evaluate the literature
• □S 4.5 Summarize the findings of a literature review
• □S 4.4 Select appropriate methods of addressing a given scholarly question
• □S 4.2 Identify ethical principles in research
• □S 4.4 Collect data for a scholarly project
• □S 4.4 Perform data analysis
• □S 4.4 Interpret and integrate data in context of existing literature
• □S 4.5 Disseminate the findings of scholarly activity, in written or oral form

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Medical Expert

• □ME 1.1 Demonstrate responsibility and accountability for patient care within the boundaries and expectations of the consultant role
• □ME 1.6 Prioritize patients based on the urgency of the clinical issue
• □ME 2.4 Establish management plans that consider all relevant aspects of the patient’s care

Collaborator

• □COL 3.2 Provide safe handover of care
• □COL 1.3 Communicate effectively with the consulting service
• □COL 2.2 Work effectively with other health care professionals when there are differences in opinion and/or recommendations

Leader

• □L 4.1 Manage time and prioritize tasks
• □L 4.1 Integrate supervisory and teaching responsibilities into the overall management of the clinical service

Scholar

• □S 3.4 Integrate best evidence and clinical expertise into decision-making

Professional

• □P 1.1 Behave in a professional manner

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Medical Expert

• □ME 1.3 Apply a broad base and depth of knowledge to the clinical management of patient presentations in Dermatology
• □ME 2.4 Establish management plans that consider all relevant aspects of the patient’s care
• □ME 4.1 Determine appropriate timing of future visits based on planned investigations, clinical status and/or anticipated clinical course

Communicator

• □COM 5.1 Document clinical encounters in an accurate, complete, and timely manner

Collaborator

• □COL 1.2 Work effectively with outpatient clinic staff

Leader

• □L 4.1 Manage time effectively to maintain clinic flow

Scholar

• □S 3.4 Integrate best evidence and clinical expertise into decision-making

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Medical Expert

• □ME 1.1 Demonstrate responsibility and accountability for decisions regarding patient care, acting in the role of most responsible physician
• □ME 1.6 Triage consultation requests based on clinical acuity
• □ME 2.4 Establish management plans that consider all relevant aspects of the patient’s care

Communicator

• □COM 5.1 Document clinical encounters in an accurate, complete, and timely manner

Collaborator

• □COL 1.2 Work effectively with outpatient clinic staff

Leader

• □L 4.2 Manage bookings to optimize clinic scheduling
• □L 4.1 Manage time effectively to maintain clinic flow
• □L 4.1 Review and act on results of investigations in a timely manner

Scholar

• □S 3.4 Integrate best evidence and clinical expertise into decision-making

Professional

• □P 1.1 Respond punctually to requests from patients or other health care professionals
• □P 1.1 Make arrangements for coverage by another physician when absent or unavailable

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Leader

• □L 4.2 Examine personal interests and career goals
• □L 4.2 Adjust educational experiences to gain competencies necessary for future practice

Scholar

• □S 1.2 Interpret data on personal performance to identify opportunities for learning and improvement
• □S 1.1 Define learning needs related to personal practice and/or career goals
• □S 1.1 Create a learning plan that is feasible, includes clear deliverables, timelines and a plan for monitoring ongoing achievement
• □S 1.1 Identify resources required to implement a personal learning plan

Professional

• □P 2.1 Demonstrate a commitment to maintaining and enhancing competence

Case description

Feedback provided

Next steps