Development of Competency Teaching and Assessment for the Subspecialty Fellowships of Internal Medicine: Infectious Diseases at Albert Einstein College of Medicine and Montefiore Medical Center June 20,2005 Grace Minamoto, M.D.

Fellowship Educational Committee for Infectious Diseases Joan Casey, M.D. Marta Feldmesser, M.D. Grace Minamoto, M.D. Simone Saltzman, M.D. Jonathan Shuter, M.D. David Stein, M.D. Fellows

How can we translate what we already do into competency teaching and assessment? How can the fellows and faculty understand how the curriculum teaches the competencies?

Competencies Reword the ACGME descriptions in terms of the subspecialty Decide how each of your curriculum components helps teach the competencies

ACGME Outcome Project: Toolbox of Assessment Methods Record review Chart stimulated recall Global rating 360 degree evaluation instrument Observed structured clinical exam (OSCE) Case logs Portfolios Written exam Standardized patient exams

Curriculum Components: ID Consultation Service Clinical conferences Case presentations Research conferences Basic science conferences Journal club Introductory lecture series I.D. Clinic Microbiology rotation Parasitology clinic STD Course Infection Control meetings Antibiotic subcommittee meetings Annual hospital in-service On-line ethics-in-research course Biostatistics and study design course AECOM Microbiology course teaching Research project

Competency 1: Patient Care in I.D. TEACHING ID Consultation Services ID Clinic ASSESSMENT Global evaluation Consultation logs Case presentation logs and evaluations Observed Consultation exercise

Competency 2: Medical Knowledge in I.D. TEACHING ID Consultation services Case presentations Conferences (clinical, research, basic science, journal club) ID Curriculum lectures Microbiology rotation STD course Parasitology clinic Research project ASSESSMENT Global evaluation Consultation logs Case presentation logs and evaluations In-service exam (ID Board review modules) Journal club presentation evaluations Microbiology course completion STD course completion Research presentation evaluation

Competency 3: Practice-Based Learning and Improvement in I.D. TEACHING I.D. Consultation Services Clinical Conferences Case presentations Journal Club I.D. Clinic AECOM microbiology course teaching ASSESSMENT Global evaluation Case presentation logs Clinic QI assessments; QI projects Case presentation evaluations Journal club presentation evaluations Biostatistics/study design course completion Research evaluations AECOM course teaching evaluation Research presentation evaluations

Competency 4: Interpersonal and Communication Skills in I.D. TEACHING I.D. consultation services I.D. clinic ASSESSMENT Global evaluation Observed consultation exercise 360 degree evaluation in clinic setting

Competency 5: Professionalism in I.D. TEACHING I.D. consultation services I.D. clinic Annual hospital in-service On-line ethics-in-research course ASSESSMENT Global evaluation Observed consultation exercise 360 degree evaluation in clinic setting Completion of annual hospital in-service Completion of on-line ethics- in-research course

Competency 6: System-Based Practice in I.D. TEACHING I.D. consultation services Clinical conference I.D. clinic Microbiology rotation Infection control in-service and meetings Antibiotic subcommittee meetings Annual hospital in-service ASSESSMENT Global evaluation Consultation logs Case presentation logs 360 degree evaluation in clinic setting Completion of microbiology rotation Participation in infection control meetings Participation in antibiotic subcommittee meetings Completion of annual hospital in- service

Competency Teaching and Assessment Requires: Faculty and fellow familiarity with competencies Time commitment by faculty to develop and reassess evaluations Evaluations that have internal consistency and inter-rater reliability Time commitment by faculty to formally evaluate fellows in multiple components of the curriculum Time commitment by other health professionals in working sphere of fellows