Development of Competency Teaching and Assessment for the

Subspecialty Fellowships of Internal Medicine:

Infectious Diseases at Albert Einstein College of Medicine

and Montefiore Medical CenterJune 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 evaluationConsultation logsCase presentation logs and

evaluationsIn-service exam (ID Board review

modules)Journal club presentation

evaluationsMicrobiology course completionSTD course completionResearch 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 evaluationCase presentation logsClinic QI assessments; QI

projectsCase presentation evaluationsJournal club presentation

evaluationsBiostatistics/study design

course completionResearch evaluationsAECOM course teaching

evaluationResearch 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 evaluationConsultation logsCase presentation logs360 degree evaluation in clinic

settingCompletion of microbiology

rotationParticipation in infection control

meetingsParticipation in antibiotic

subcommittee meetingsCompletion 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