The ACGME COMPETENCIES

1. The ACGME COMPETENCIES Joan E. St. Onge, M.D. EmergencyMedicine Residency Faculty Development DATE

2. Past Present • 24/7 • “See one, do one, teach one” • Service vs • education • Time = ready for independent practice • Duty Hours • Simulation and focus on patient safety • Education vs. • Service • Competency = ready for independent practice

3. 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

4. ACGME Outcomes Project • Competency evaluation stalls at individual programmatic definitions • MedPac, IOM, and others question the process of accreditation • preparation of graduates for the “future” health care delivery system • House of Representatives codifies “New Physician Competencies” • MedPacrecommends modulation of IME payments based on competency outcomes

6. Competency Based Education Independent Practice Medical School Graduation

7. 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

8. 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

9. 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?”

10. 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

11. Interpersonal and Communication Skills • Demonstrate interpersonal and communication skills that result in effectiveinformation 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.

12. 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

13. Next : • Methods of Evaluation • The Milestones • Entrustable Professional Activities