department of graduate medical education (gme) overview of the acgme core competencies

Department of Graduate Medical Education (GME)

Overview of the ACGME Core Competencies


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.


Six ACGME Core Competencies


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)


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)


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)


• 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

PRACTICE-BASED LEARNING


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


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.


• 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



• 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.



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


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.



• 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.



• 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



• 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



• 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.


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


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.


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


PROFESSIONALISM/ETHICS

• Malpractice and other grievance procedures • Facilitate appropriate termination of doctor-patient

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


Questions ?