Competency Based Curriculum

 

 

 

Program: Internal Medicine

 

Program Director: Mohamed Siddique, MD

Specialty/Course: Ambulatory Medicine

Curriculum Coordinators: 1.Raylene Platel, MD,MPH

                                           

 

Administrative Support: Kim Bardwell, RN

 

Date Revised: 02/11/2009

 

 

 

 

Competency

 

Objectives

Specific

 

Educational Experiences

Knowledge/ Skills

Integration/Application

 

 

Assessment

Tools

 

 

Patient Care

that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health

1.   Learner based and not teacher based education.

2.   Learners should be able to examine patients efficiently and accurately

3.   Learner should have respect for patient  and primary service preferences

4.   Physician in training should develop and master the following skills:

1.   Interviewing

2.   Performance of routine physical exam

3.   Counsel and Educate patients and families

4.   Preventive health care

 

1. Perform Medical Consultations

2. Preceptor Discussions

3. Morning report

4. M & M conference

5. Medical grand rounds

6. Ambulatory care clinic training

7. PERKS (Promoting Excellence in Resident’s Knowledge and Skills) – OSCE

8. Clinic Article Discussions

 

1.   Quartely evaluation by Preceptor

2.   360-degree survey*

3.   PERKS – Evaluated at the end of each session - OSCE

4.   Consultation Discussions

5.   Documentation Evaluation

6.   Communication with the Patient

 

 

 

 

 

 

Medical Knowledge

about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care

 

1.   Demonstrate working knowledge of initial therapy for common and serious medical problems

2.   Demonstrate working knowledge of topics common to medical consultations.

3.   Commitment to continuous learning

4.   Develop comprehensive understanding of complex medical problems

5.   Demonstrate analytical thinking

 

1.   Preceptor Discussions

2.   Morning report

3.   Board review course for PGY-II and IIIs

4.   Medical grand rounds

5.   M & M

6.   Clinic Article Discussions

 

 

1.   Monthly exam for all house staff

2.   Competency-based Testing

3.   Monthly PERKS program - OSCE

4.   Quarterly evaluation by Preceptor

5.   Case Discussions with Preceptor

6.   Clinic Article Discussions

 

 

 

 

 

 

Interpersonal and Communication Skills

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

 

1.   Communicate effectively with primary service

2.   Demonstrate effective patient/family interviewing skills

3.   Establish excellent relationships with patients/families

4.   Able to educate and counsel patient/families

5.   Improve listening skills

6.   Able to maintain comprehensive, timely, legible medical records

 

 

1.   Annual bed side exam

2.   PERKS program - OSCE

3.   Oral/Poster presentation and discussion

4.   Peer-group discussion

5.   CD-ROM (Buckman)

6.   Writing follow-up notes

7.   Communication with the Patient

 

1. Documentation Evaluation

2. Communication with the Patient

3. 360 degree Evaluations

 

 

 

 

 

 

Professionalism

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

 

1.   Treat patient and families with respect and consideration

2.   Treat nursing and other health care professional with respect

3.   Understand issues of race, religion, sexual orientation, disability, age, culture, gender etc. in patients and other health care providers

4.   Always respect patients’ autonomy

5.   Serve the interest of the patients

6.   Maintain trust by managing conflicts of interest

7.   Always be honest with patients

8.   Always maintain patients’ confidentiality

9.   Strive to improve patients’ quality of care

10. Maintain appropriate relations with patients

 

1.   Noon lectures by faculty

2.   Daily interaction with health care professionals

3.   Peer-group discussion

4.   Faculty Role modeling

 

 

1.   Quarterly rotation evaluation by attending

2.   360-degree survey*

 

 

 

 

 

 

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

 

 

1.   Learn and demonstrate knowledge of scientific study design and statistical methods

2.   Learn to accept feedback from others

3.   Regularly self-assess

4.   Use information technology to manage information, access on-line medical information and support their own education on a regular basis

Facilitate learning of others

 

1.   Ambulatory lectures

2.   Daily clinical question with EBM research and answer.

3.   Journal club, M & M exercises

4.   Book: Users’ guides to the Medical Literature (JAMA)

5.   Use of standard order sets/clinical pathways to promote optimal cost effective care

6.   Self-directed inquiry

7.   Interactive computer programs

 

1.   Residents’ Grand Round presentation

2.   Residents’ Update presentation

3.   Poster/Oral presentation at scientific meetings i.e. ACP-MI Chapter, National Meetings, annual Departmental research day

4.   Periodic chart audit for compliance with current guidelines and compare to NCQA benchmarks

5.   360-degree survey*

6.   Evaluation of Daily clinical question with EBM research and answer.

 

 

 

 

 

 

 

Systems-Based Practice

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

 

1.   Participate efficiently in multidisciplinary discharge planning and follow-up

2.   Practice cost-effective care

3.   Learn to minimize patient care errors

4.   Understand various types of health insurances and how it impacts patient care in both in-patient/out-patient settings i.e. LOS, UR and prescriptions

5.   Advocate for patients within the health care system

6.   Social Service Skills

a.   Evaluation for Disability

b.   Coordinate with visiting nurses for patient care

 

1.   Daily interaction with nurse care coordinator

2.   Multidisciplinary health care team rounds

3.   Net learning

4.   M & M conference

5.   Noon lectures by faculty on the following topics:

§1   Introduction to Managed Care

§2 Insurances

§3 Negotiating Managed Care Contracts

 

 

1.   360-degree survey*

2.   Quarterly evaluation by Preceptor

3.   Preceptor discussions

 

 

 

Resource Materials

 

Recommended Textbooks:

     Harrison’s Principles of Internal Medicine, 17th edition

     Principles of Ambulatory Medicine, 6th edition

     Office Procedures, By Thomas Zuber, MD

 

Relevant Practice Guidelines:

     JNC VII Guidelines for Hypertension Management

     Standards of Medical Care for Patients with Diabetes mellitus, ADA

     National Cholesterol Education Program – ATP III

     American Cancer Society Guidelines for Early Cancer Detection

     NAEPP Guidelines for Asthma Management

     NHLBI Guidelines for the Management of Obesity

     Perioperative Cardiovascular Evaluation for Noncardiac Surgery – ACC

     Evaluation and Management of Chronic Heart Failure in the Adult - ACC

 

Electronic/Web Based Resources:

     http://www.annals.org/intheclinic/

     www.nhlbi.nih.gov

     www.acc.org

     http://care.diabetesjournals.org/content/vol27/suppl_1/

 

Yale Curriculum http://www.sgintmed.com/schedules/april%20schedules/april%202008/Resident%20PDF%20Outside/Table%20of%20Contents.pdf

List of Topics for Clinic article discussion: