endocrinology curricular milestones · (prof4) 12 mo 24 mo a. behaves in an ethical and...
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ENDOCRINOLOGY CURRICULAR MILESTONES
NEXT ACCREDITATION SYSTEM TASK FORCE
Patient Care
68
1. Gathers and synthesizes essential and accurate informationto define each patient’s clinical Endocrine problem(s). (PC1)
12 mo 24 mo
A. Obtains a complete history from review of medical records/clinical encounter (e.g. chief endocrine complaint, history of present illness, review of systems, past medical history, social history, family history, list of medications, allergies, laboratory studies and imaging results)and includes relevant disease specific historical information (e.g. the salient positive and negative findings).
X
B. Performs a complete physical exam and is able to identify physical findings pertinent to the endocrine system.
X
C. Able to effectively teach history and physical exam pertinent to the endocrine system. X
Evaluation Tools: Direct observation, multisource feedback, chart audits
2. Develops and achieves comprehensive management plan forEndocrine disorders in each patient. (PC2)
12 mo 24 mo
A. Analyzes clinical data and prioritizes medical problems in order to develop patient specific diagnostic/management strategies for endocrine disorders.
X
B. Monitors clinical progress and modifies care plan based on the clinical course.
X
C. Develops a comprehensive management plan by collaborating with an interdisciplinary team of health care providers XD. Reviews and utilizes current literature to guide diagnostic/therapeutic decisions. X
Evaluation Tools: Direct observation, multisource feedback, chart audits
69
3. Manages Endocrine patients with progressive responsibilityand independence. (PC3)
12 mo 24 mo
A. Under supervision, provides appropriate care for patients with a broad spectrum of endocrine disorders.
X
B. Seeks additional guidance and/or consultation as appropriate. X
C. Capable of independently providing care for patients with a broad spectrum of endocrine disorders. X
Evaluation Tools: Direct observation, multisource feedback, chart audits
4a. Skill in performing and interpreting invasive procedures. (PC4a)
12 mo 24 mo
A. Obtains informed consent (e.g. reviews the procedure, risks, benefits, alternate therapies and any conflict of interest).
X
B. Maintains an accurate and updated procedure log X
C. Competently performs and/or interprets the following procedure (as per ABIM approved curriculum):
1) Thyroid ultrasound and thyroid nodule aspiration X
Evaluation Tools: Direct observation, multisource feedback, chart audits
70
4b. Skill in performing and interpreting noninvasive testing. (PC4b)
12 mo 24 mo
A. Obtains informed consent (e.g. reviews the procedure, risks, benefits, alternate therapies and any conflict of interest).
X
B. Maintains an accurate and updated procedure log X
C. Appropriately orders and interprets dynamic testing (e.g. suppression and stimulation testing).
X
D. Competently coordinates, performs and/or interprets the following non-invasive procedures (as per ABIM approved curriculum):
1) Bone densitometry by DXA X
2) Insulin pump management X
3) Continuous glucose monitoring X
5. Provides consultative Endocrine care and requestsinvolvement of other services as appropriate. (PC5)
12 mo 24 moA. Effectively explains the nature of the endocrine disease, diagnostic approach, therapeutic options, potential side effects and expected course to patients/families.
X
B. Effectively communicates medical information to other health care providers in verbal and written format.
X
C. Appropriately identifies/utilizes consult subspecialty and ancillaryservices. X
Evaluation Tools: Direct observation, multisource feedback, chart audits
71
Medical Knowledge
6. Clinical Knowledge of Endocrine Disorders. (MK1)
12 mo 24 mo
Knows the normal physiology, pathophysiology, differential diagnosis, natural histories, characteristic history, physical exam findings, diagnostic strategies and therapeutic options for a broad range of endocrine disorders across the age spectrum.
a) Pituitary and Neuroendocrine Disorders X
b) Adrenal Disorders X
c) Thyroid Disorders X
d) Disorders of Bone, Mineral and Parathyroid X
e) Diabetes and Hypoglycemia X
f) Nutrition, Obesity and Lipids X
g) Gonadal Disorders X
h) Reproductive Endocrinology including Pregnancy X
i) Disorders of Growth and Development X
Evaluation Tools: In-training exam, direct observation, multisource feedback, chart audits
72
7. Knowledge of Diagnostic Testing and Procedures forEndocrine Disorders. (MK2)
12 mo 24 mo
A. Knows the policies/procedures involved in assuring patient safety when performing endocrine procedures, including obtaining informed consent and patient verification.
X
B. Knows the appropriate use/interpretation/limitations of radiologicand laboratory studies used in the evaluation/management of a broad range of endocrine disorders.
X
Evaluation Tools: Direct observation, multisource feedback, chart audits
8. Scholarship. (MK3)
12 mo 24 mo
A. Participates in scholarly investigation (e.g. research investigation, QI projects). X
B. Contributes to relevant scholarship (e.g. abstracts, case presentations, reviews, original research). X
C. Prepares effective presentations covering an array of clinical topics, journal articles, research ideas and quality projects. X
Evaluation Tools: Direct observation, multisource feedback
73
System Based Practice
9. Works effectively within an interprofessional team (e.g.peers, consultants, nursing, ancillary professionals and other support personnel). (SBP1)
12 mo 24 mo
A. Advocates effectively for patient care and resources (e.g. other health care providers, caregivers, schools and insurance companies) X
B. Appropriately utilizes medical and non-medical specialty consultation (e.g. social work, foreign language interpreters, ethics committee, risk management, case management and pastoral care)
X
Evaluation Tools: Direct observation, multisource feedback, chart audits
74
10. Recognizes system error and advocates for system improvement.(SBP2)
12 mo 24 mo
A. Understands how different health systems (e.g. VAMC, ACO),programs (e.g. bariatric program) and protocols (e.g. inpatient insulin drip protocols) impact patient care. Uses the above appropriately.
X
B. Identifies problems in medical education, research, clinical care and/or patient safety. Designs and implements solutions (e.g. QI project).
X
Evaluation Tools: Direct observation, multisource feedback, chart audits
11. Identifies forces that impact the cost of health care, andadvocates for, and practices cost-effective care. (SBP3)
12 mo 24 mo
A. Understands the cost of various treatment/testing strategies including financial implication and health outcomes. X
B. Provides cost-effective and quality patient care for endocrineproblems. X
Evaluation Tools: Direct observation. multisource feedback, chart audits
75
12. Transitions patients effectively within and across healthdelivery systems. (SBP4)
12 mo 24 mo
A. Effectively provides care within and transitions care between different clinical environments (e.g. inpatient consult service, outpatient clinical visits, telephone management).
X
B. Demonstrates understanding and navigates the complex health care system (e.g. insurance plans and institutions). X
Evaluation Tools: Direct observation. multisource feedback, chart audits
Practice Based Learning and Improvement
76
13. Monitors practice with a goal for improvement. (PBLI1)
12 mo 24 mo
A. Monitors knowledge base and practice patterns to improve patient care (e.g. self reflection, feedback, evidence based literature). X
B. Implements changes to improve patient care (e.g. quality improvement projects, chart audit and literature review ). X
Evaluation Tools: Direct observation, multisource feedback, chart audits
14. Learns and improves via performance audit. (PBLI2)
12 mo 24 mo
A. Prepares, presents and participates in clinical conferences (e.g. critically examines presented information, asks questions and clarifications, “thinks out loud”, modifies presentation or understanding based on feedback).
X
B. Learns and improves performance based on feed back from in-training exam, chart reviews, direct observations and other evaluations.
X
Evaluation Tools: In-training exam, direct observation, multisource feedback, chart audits
77
15. Learns and improves via feedback. (PBLI3)
12 mo 24 mo
A. Actively seeks feedback, advice and knowledge from all of the following: supervising physicians, experts in the field and other health care providers.
X
B. Identifies deficiencies and improves gaps in knowledge base/clinical skills. X
Evaluation Tools: In-training exam, direct observation, multisource feedback, chart audits
16. Learns and improves at the point of care. (PBLI4)
12 mo 24 mo
A. Effectively utilizes health information technology. X
B. Analyzes research data, synthesizes practice guidelines and appropriately incorporates new information into clinical practice. X
Evaluation Tools: In-training exam, direct observation, multisource feedback, chart audits
78
Professionalism
17. Has professional, respectful interactions with patients, caregiversand members of interprofessional team (e.g. peers, consultants, nursing, ancillary professionals and support personnel). (PROF1)
12 mo 24 mo
A. Interacts with patients, family members and members of the health care team in a professional, culturally sensitive manner using appropriate verbal/nonverbal language.
X
B. Maintains proper professional boundaries and avoids any breach of these boundaries. X
Evaluation Tools: Direct observation, multisource feedback
79
18. Accepts responsibility and follows through on tasks. (PROF2)
12 mo 24 mo
A. Fulfills all clinical and academic responsibilities in a timely,appropriate fashion. X
B. Participates regularly in professional development and/or continuing medical education activities. X
Evaluation Tools: Direct observation. multisource feedback, chart audits
19. Responds to each patient’s unique characteristics and needs.(PROF3)
12 mo 24 mo
A. Discloses information regarding risks/benefits/costs of various diagnostic and treatment options utilized for endocrine disorders. Discloses any potential conflicts of interest.
X
B. Accommodates patients of different religions, sexual orientations and cultural backgrounds in delivering medical care. Uses language that is neutral as to assumptions of gender, sexual preference, religion, race and ethnicity.
X
C. Maintains patient confidentiality except where provided for by law (e.g. suspicion of abuse or neglect, need to protect the welfare of the individual patient or the public interest, etc.).
X
Evaluation Tools: Direct observation, multisource feedback, chart audits
80
20. Exhibits integrity and ethical behavior in professional conduct.(PROF4)
12 mo 24 mo
A. Behaves in an ethical and professional manner in all actions. X
B. Truthfully reports personal or system based medical errors,conflicts of interest and/or professional misconduct.
X
C. Places patient safety above competing considerations without compromising own safety or the safety of others.
X
Evaluation Tools: Direct observation, multisource feedback, chart audits
Interpersonal and Communication Skills
81
21. Communicates effectively with patients and caregivers. (ICS1)
12 mo 24 mo
A. Approaches patients/families in a friendly, interested, and respectful demeanor. X
B. Clearly explains medical information without using unnecessary jargon. X
Evaluation Tools: Direct observation, multisource feedback
22. Communicates effectively in interprofessional teams (e.g. peers,consultants, nursing, ancillary professionals and other support personnel). (ICS2)
12 mo 24 mo
A. Presents history, physical exam, differential diagnosis, diagnosticstrategy and therapeutic approach in a clear, concise manner in verbal format.
X
B. Presents history, physical exam, differential diagnosis, diagnosticstrategy and therapeutic approach in a clear, concise manner in written format.
X
Evaluation Tools: Direct observation, multisource feedback, chart audits
82
23. Appropriate utilization and completion of health records.(ICS3)
12 mo 24 mo
A. Maintains complete and accurate record of each clinical encounter (e.g. clinical visits, telephone encounters, letters, etc.). X
B. Completes all documentation in a timely fashion. XEvaluation Tools: Direct observation, multisource feedback, chart audits
83