Transcript Department of Graduate Medical Education (GME)

Overview of the ACGME
Core Competencies
Department of Graduate Medical Education (GME)
Why all faculty should know the
six core competencies…
1. All resident/fellow education experiences and
curriculum are developed around the six core
competencies.
2. The educational experiences and evaluations of
residents should, therefore, also be closely linked to
these core competencies
3. The ACGME site visitor will ask about your
knowledge of the six core competencies during faculty
interviews. You should be able to provide examples of
how you model, teach and evaluate these
competencies.
Department of Graduate Medical Education (GME)
Six ACGME Core Competencies
Department of Graduate Medical Education (GME)
MEDICAL KNOWLEDGE
• Objective evidence of satisfactory
performance on:
–
–
–
–
–
Mock boards
In-service examination
ED “pre-call” exam (“credentialing exam”)
Pre/post rotation examinations
ABR exams (physics and written portions)
Department of Graduate Medical Education (GME)
PATIENT CARE
• Documentation of reducing the
discrepancy rate between preliminary
interpretations rendered by residents
during independent call and the final
interpretations
• Documentation of demonstrated
competency in performing procedures (e.g.
step by step check off for performance of
specific procedures)
Department of Graduate Medical Education (GME)
PRACTICE-BASED LEARNING
• Documentation of remediation of resident
weak area(s) identified on:
–
–
–
–
in-service exams
Annual resident self-assessment
Post rotation exam
Trends identified by review of missed cases (e.g.
frequently misses cervical spine findings)
• Documentation of acquisition of new
knowledge (to allow effective utilization of
new modality or technique)
Department of Graduate Medical Education (GME)
PRACTICE-BASED LEARNING
• Gather pertinent information – including medical interview skills;
selective and efficient use of physical examination skills; selective
and efficient use of laboratory and radiologic information; use of
patient records and other clinical information sources; effective
time management skills.
• Documentation of patient encounter – patient history and physical
data; laboratory/radiologic data; formulation of treatment plans;
timely entry of information into medical record.
• Documentation and clarity of medications – including
chemotherapy, antibiotics, blood products, growth factors
prescribed and/or administered
• Planning and coordinating follow up care – knowledge of referral
mechanisms; knowledge of extended care systems including home
based care
• Demonstrate ability to act as patient advocate
Department of Graduate Medical Education (GME)
INTERPERSONAL/COMMUNICATION
SKILLS
• Documentation of review of specified number
of dictated reports for each resident with
improved results following remediation of
any deficiencies
• Documentation of remediation of any
resident communication deficiency identified
on 360 or faculty evaluations
• Documentation of participation in formal
institutional or inter/intradepartmental
exercises on communication skills
Department of Graduate Medical Education (GME)
Interpersonal and Communication
Skills
• Fellows must be able to demonstrate interpersonal
and communication skills that result in effective
information exchanged and teaming with patients,
the families of patients, and professional associates.
Fellows are expected to:
– Create and sustain a therapeutic and ethically sound
relationship with patients
– Use effective listening skills and elicit and provide
information using verbal and writing skills.
– Work effectively with others as a member or leader of a
health care team or other professional group.
Department of Graduate Medical Education (GME)
Interpersonal and Communication
Skills
• Fellows must demonstrate the following
behaviors:
– Availability and accessibility to other providers
– Cooperation with nursing and other health
professionals
– Provision of care and comfort in addition to other
treatments, including appropriate spiritual and
social support
– Communication with patient and other health care
providers
– Striving for personal development
Department of Graduate Medical Education (GME)
Interpersonal and Communication
Skills
• Interpersonal skills with patients and health
providers – establish a personal relationship;
ascertain patient goals; ascertain patient compliance;
effectively communicate plan of treatment
• Function effectively as a member of an
interdisciplinary health care team – this includes
developing a treatment and intervention strategy for
patients, facilitating effective consultations,
demonstrating knowledge of role and function of
each relevant discipline.
Department of Graduate Medical Education (GME)
SYSTEMS-BASED PRACTICE
• Documentation of preparation and
presentation of QA or systems-related
project
• Documentation of resident participation
in departmental QI or systems related
conferences
Department of Graduate Medical Education (GME)
Systems-Based Practice
• Fellows must demonstrate an awareness of
and responsiveness to the larger context and
system of health care and the ability to
effectively call on system resources to
provide care that is of optimal value.
Department of Graduate Medical Education (GME)
Systems-Based Practice
• Quality Assessment and Quality
Improvement
– Understand principles and objectives of quality
assessment of procedures and clinical care
– Demonstrate knowledge of the process of
quality assessment and use of outcome data to
improve quality assessment and use of outcome
data to improve quality of delivered care.
Department of Graduate Medical Education (GME)
Systems-Based Practice
• Specifically, fellows are expected to:
– Understand how their patient care and other
professional practices affect other healthcare
professionals, the health care organization, and
the larger society and how these elements of the
system affect their own practice
Department of Graduate Medical Education (GME)
Systems-Based Practice
• Know how types of medical practice and
delivery systems differ from one another,
including methods of controlling health care
costs and allocating resources
• Practice cost-effective health care and
resource allocation that does not
compromise quality of care
Department of Graduate Medical Education (GME)
Systems-Based Practice
• Advocate for quality patient care and assist
patients in dealing with system complexities
• Know how to partner with health care
managers and health care providers to
assess, coordinate, and improve health care
and know how these activities can affect
system performance.
Department of Graduate Medical Education (GME)
PROFESSIONALISM
• Documentation of remediation of deficiency
related to professionalism identified on 360
or faculty evaluations
• Documentation of compliance with, or
remediation of failure to comply with,
departmental, institutional, and/or
governmental regulations
• Documentation of remediation of deficiency
in conference attendance
Department of Graduate Medical Education (GME)
PROFESSIONALISM
• Fellows must demonstrate a commitment to carrying out
professional responsibilities, adherence to ethical principles, and
sensitivity to a diverse patient population. Specifically, fellows are
expected to:
• Demonstrate respect, compassion, and integrity; a responsiveness to
the needs of patients and society that supersedes self-interest;
accountability to patients, society, and the profession; and a
commitment to excellence and on-going professional development.
• Demonstrate a commitment to ethical principles pertaining to
provision or withholding of clinical care, confidentiality of patient
information, informed consent, and business practices
• Demonstrate sensitivity and responsiveness to patients’ culture, age,
gender, and disabilities.
Department of Graduate Medical Education (GME)
PROFESSIONALISM/ETHICS
• Promote patient autonomy in decision
making
• Preserve confidentiality of information,
including compliance with HIPAA
• Help patients consider/select advance
directives
• Principles of informed consent
Department of Graduate Medical Education (GME)
PROFESSIONALISM/ETHICS
• Malpractice and other grievance procedures
• Facilitate appropriate termination of doctorpatient relationship and transfer of care
• Reproductive issues as they pertain to the
management of patients with hematologic and
oncologic disorders, HIV infection and the side
effects of therapies
• Demonstrate skill in delivery of prognostic
information, as well as understand the principles
of medical futility
Department of Graduate Medical Education (GME)
Questions ?
Department of Graduate Medical Education (GME)