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Douglas Char, MD – Emergency Medicine Most days I feel like this! I want to be part of this! ACGME RRC.

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Presentation on theme: "Douglas Char, MD – Emergency Medicine Most days I feel like this! I want to be part of this! ACGME RRC."— Presentation transcript:

1 Douglas Char, MD – Emergency Medicine Most days I feel like this! I want to be part of this! ACGME RRC

2 Emergency Medicine Background WU 48 residents, 12/class, PGY1-4 EM RRC selected 23 milestones – Assessment at POC – 24/7/365 supervision

3 Evaluation Tools Out with the old, in with the new? How to decide what new tools are needed, where to get them? How to train faculty in their use, effectiveness, return rates?

4 CORD WIKI – Organic, collaborative

5 Where to begin? Lack of clear understanding what RRC wants Overwhelming – where to start? Wholesale overhaul versus temporary revisions – High impact assessments ED shift cards Quarterly global faculty rating Procedures and follow up cases – Lesser impact End of rotation, off-service

6 End of Shift Cards End of rotation eval not terribly helpful Multiple faculty-resident pairings in a month Old paper system – 5 point Likert scale – Everyone rated - “3”, limited comments - “solid” – Chasing paper, tedious to enter into spreadsheet Electronic format – iPads, hand held devices – Milestone based language – Completed on the spot – Snippets combined => bigger picture

7 End of Shift Evaluation Encourages daily feedback – Formative, resident driven Focusing on specific behavior - Combat “grade inflation” iOS data processing limitations Struggle to get actionable comments

8 Resident Dashboard

9 Procedures and Patient Interactions Numbers ≠ Competency Direct Observation – skill sheets (procedure milestones, ICS, SBP) – Airway, wound care, resusc, ultrasound, pain control 360 evaluation – patients, nurses, peers (PROF, ICS) Some specific milestones

10 Milestone; PC10 Covers level 1-4 behavior

11 Monthly Rotations Took existing evaluation tools that were CC based and mapped milestones to document PC 2,3 PBL1 MK 1 Rotations specific behaviors also mapped where appropriate

12 Quarterly Faculty Group Evals Review one class each month (during Div mtg) – Summative Check sheet historically not helpful so reverted to general open-ended verbal comments PD then takes notes and completes summative eval that uses milestone-based language – Assessment is done in each of the 6 core competencies with behavior anchors – Statements mapped to milestones Still mainly “group gestalt” as reliable, reproducible competency data hard to generate

13 Faculty Group Evaluation Dreyfus model of skill acquisition

14 Waiting for New Innov (commercial vendors) to come up with workable platforms Focusing on content of evaluations more than numbers Have to show residents and faculty that the evaluations add value – help guide and change practice


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