ACGME Competencies

I What are the ACGME Educational Competencies?
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1. Medical Knowledge
a. Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care
b. Assessment examples: yearly in training exams, monthly tests, clinical discussions
c. Faculty goals
i. To educate residents at the bedside as well as in a didactic format
ii. To educate residents in preparing for their board exams through board review sessions, journal clubs and mentoring groups

2. Patient Care
a. Residents must be able to provide patient care that is
compassionate, appropriate, and effective for the treatment
of health problems and the promotion of health.
b. Assessment examples: daily rounds/patient discussion, direct
observation of patient encounters, 360 degree evaluation
c. Faculty goals:
i. To ensure that residents are educated on a diverse group of
patients with a variety of medical problems
ii. To educate residents at the bedside as well as in a didactic
format.

3. Practice Based Learning and Improvement
a. Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning.
b. Assessment examples: articles in medical record, review of literature review completed by residents, journal club
c. Faculty goals:
i. To teach the residents using literature review
ii. To use journal club
iii. To have didactics be evidenced-based

4. Systems-Based Practice
a. Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care.
b. Assessment examples: problem based learning project,
c. Faculty Goals:
i. To display functional working in various health care delivery settings and systems relevant to their clinical specialty;
ii. To educate residents on cost awareness and risk-benefit analysis in patient and/or population-based care as appropriate;
iii. To work in interprofessional teams to enhance patient safety and improve patient care quality
iv. To educate residents about identifying system errors and implementing potential systems solutions.

5.Interpersonal and Communication Skills
a. Residents must demonstrate interpersonal and communication skills that result in the effective exchange of
information and collaboration with patients, their families, and health professionals.
b. Assessment examples: 360 evaluations, direct observation of encounters, patient evaluations
c. Faculty goals:
i. To set an example with staff and patients displaying good communication and respect.
ii. To communicate effectively with patients, families,
and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds;
iii. To communicate effectively with physicians, other health professionals, and health related agencies;
iv. To maintain comprehensive, timely, and legible medical records

6. Professionalism
a. Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles.
b. Assessment examples: conference attendance, 360 degree evaluations, direct observation, duty hours logged, dictations completed in timely manner
c. Faculty goals:
i. To show compassion, integrity, and respect for others
ii. To show respect for patient privacy and autonomy and instruct residents on how to go about this
iii. To show sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation.
iv. To show respect for other health professionals in the clinical situation

UT Internal Medicine experience in measuring the Six Competencies.
“Whatever we measure, we tend to improve”
“These competencies and attempts to assess them contribute to the medical profession’s attempt to regulate itself ”.
“Competence develops over time and is nurtured by reflection on experiences”
Dr David Leach

“To become competent you must feel bad”
Hubert Dreyfus

Measuring the competencies involves collecting all the activities that represents the 1) resident’s efforts, 2) progress and the 3) achievements in multiple areas of the curriculum.

Advantages:
1) To better understand how to integrate the competencies into education.
2) Mold the education of the six competencies to a more instructive task.
3) Assessment results can provide formative and summative feedback to residents.

The score card was reviewed with the residents and with the faculty. We started to implement it in January 2010.

Medical Knowledge:
We use the following tools to quantify medical knowledge:
1) Monthly test.
2) National In-Training Exam.
3) New Innovations (Global Assessment)/ Faculty assessment.