Joan E. St. Onge, M.D. UMMSM At Holy Cross Hospital Internal Medicine Residency Faculty Development January 23, 2013 The Evaluation Toolkit

The Evaluation Toolkit and Intro to Curriculum Development Review of the Competencies Review of the evaluation methods for residency education Matching of evaluation tools to the competencies Distribution of sample of curricula

ACGME OUTCOMES PROJECT Response to the Institute of Medicine : “To Err is Human” 6 core competencies developed by the ACGME Aim: Demonstrate the outcomes of graduate medical education program in a meaningful, demonstrable way To the public To the governing bodies ( US congress, states legislatures) To the patients To the profession

Competency Based Education Medical School Graduation Independent Practice

Patient Care Resident must be able to provide care that is compassionate, appropriate and effective for the treatment of health problems and the promotion of health. Information gathering, ( H &P) Differential diagnoses Management plan Counseling Use of resources: Cost Effective Care

Patient Care How do you evaluate a resident’s ability to provide patient care? Direct observation oData gathering oPhysical exam skills oCritical thinking oCounseling What venue? Bedside? Simulation lab? Review of charts Review of outcomes Medical Knowledge assessment

Medical Knowledge Resident must demonstrate knowledge about the established and evolving biomedical clinical and cognate ( epidemiological and social-behavior) sciences and the application of this knowledge to patient care. Cites the literature Preparation Application Analytical thinking

Medical Knowledge How do you assess Medical Knowledge? Conferences Chart Review Direct Observation Bedside and Simulation Examination In Training Exam Pre and post tests On line Education Modules

Practice Based Learning Resident must be able to investigate and evaluate his or her practices, appraise and assimilate scientific evidence, and improve patient care practices. “What can I do better?” “How do I measure the effect of change in practice?” “What clinical questions can I generate from my patient, and how do I answer them?” “What does the evidence say?”

Practice Based Learning How do you evaluate practice based learning? Direct Observation Journal Club Chart Review Clinical practice Review Self Assessment and Learning Plans

Professionalism Resident must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population. Honesty, respect, reliablity Cultural competence Commitment to excellence

Professionalism How do you Evaluate Professionalism? Direct Observation Evaluations of residents by patients, nurses, peers.

Interpersonal and Communication Skills Demonstrate interpersonal and communication skills that result in effective information exchange and collaboration with patients, their patients’ families, and professional associates Create and sustain therapeutic relationship Use effective listening skills; elicit and provide information: verbal, nonverbal, written Works effectively with others.

Interpersonal and Communication Skills How do you evaluate Interpersonal and Communication Skills? Direct Observation Chart review 36o evaluations

Systems Based Practice The resident must demonstrate awareness and responsiveness to the larger context of health care and the ability to effectively call on system resources to provide care that is of optimal value. Knowledge of Delivery systems Cost effectiveness Advocate for quality of care for patients Partner with others to coordinate care

Systems Based Practice How do you evaluate Systems Based Practice? Evaluation of Discharge process Follow Outcomes Multidisciplinary rounds Patient evaluations

Curriculum Development