The New ACGME Competencies for Internal Medicine

The New Competencies for Internal Medicine

ACGME Outcomes project

Applies to all disciplines

Implemented as of 7/1/02

New evaluation forms

New Learning Objectives

The six general competencies:

Patient Care

Medical Knowledge

Professionalism

Systems-based Practice

Practice-based Learning and Improvement

Interpersonal and Communication Skills

Patient Care

Patient Care: Residents are expected to provide patient care that is compassionate, appropriate andeffective for the promotion of health, prevention of illness, treatment of disease and at the end of life.

Medical Knowledge

Medical Knowledge: Residents are expected to demonstrate knowledge of established and evolving biomedical, clinical and social sciences, and the application of their knowledge to patient care and theeducation of others.

Practice-Based Learning and Improvement

Practice-Based Learning and Improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care

Practice-Based Learning and Improvement:

Residents are expected to be able to use scientific evidence and methods to investigate, evaluate, and improve patient care practices. EBM, literature searching, information

technology, teaching

Interpersonal and Communication Skills

Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families, and other health professionals

Interpersonal and Communication SkillsResidents are expected to demonstrate interpersonal and communication skills that enable them to establish and maintain professional relationships with patients, families, and other members of health care teams.

Professionalism

Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population

Professionalism

Residents are expected to demonstrate behaviors that reflect a commitment to continuous professional development, ethical practice, an understanding and sensitivity to diversity and a responsible attitude toward their patients, their profession, and society.

Systems-Based Practice

Systems-Based Practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value

Systems-Based Practice

Systems-Based Practice: Residents are expected to demonstrate both an understanding of the contexts and systems in which health care is provided, and the ability to apply this knowledge to improveand optimize health care.

Systems-Based Practice

Understand, access and utilize the resources, providers and systems necessary to provide optimal careUnderstand the limitations and opportunities inherent in various practice types and delivery systems, and develop strategies to optimize care for the individual patientApply evidence-based, cost-conscious strategies to prevention, diagnosis, and disease managementCollaborate with other members of the health care team to assist patients in dealing effectively with complex systems and to improve systematic processes of care

Professionalism

Increasing emphasis in licensure

Like pornography- “easy to recognize but difficult to define”

How physicians meet their responsibilities to individual patients and to communities

Professionalism

ABIM- “comprises those attitudes and behaviors that sustain the interests of the patient above one’s own self interest…and entails altruism, accountability, commitment to excellence, duty and …respect for others.”

Medical Professionalism

National focus on defining and measuring professionalism

[Hundert]

Medical Professionalism:

Physicians subordinate their own interests to the interests of others

Physicians adhere to high moral and ethical standards

Physicians respond to societal needs

Medical Professionalism:

Physicians evidence core humanistic values, including honesty, integrity, caring and compassion, altruism and empathy, respect for others, and trustworthiness

Physicians demonstrate accountability for themselves and their colleagues

Medical Professionalism:

Physicians demonstrate a continuing commitment to excellence

Physicians demonstrate a commitment so scholarship and to advancing their field

Physicians reflect upon their actions and decisions

Medical Professionalism: Example of common pitfallsInappropriate expressions of anger at patients, families or other health care professionalsPublicly belittling patients, families or colleaguesDisrespect for patients because or their disease, lifestyle or backgroundCompromising care to “get out early”

Learning Medical Professionalism:

The “Hidden Curriculum”

Role models

Life-long learning/ self reflection