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

Gathers essential/accurate information via interviews and physical exams and reviews other data.

Competently performs some invasive procedures Prioritizes Knows indications, contraindications, & risks of some invasive procedures

a patient's problems

Prioritizes a day of work

Monitors and follows up patients appropriately

Provides services aimed at preventing or maintaining health such as immunization based upon current guidelines.

Works with all health care professionals to provide patient-focused care.

Writes pertinent and organized notes

Has timely and legible medical records

Has a good understanding of rational use of diagnostic tests.

Has a good knowledge and understanding of how and when to utilize the services of specialists, consultants and other services.

Develops skills needed to interpret peripheral smears, urine microscopy, gram stain, X-rays, CT scans and ECGs.

5 – 6 Months of general medical ward experience. Admits and directly responsible for the care of patients during long and short call.

Performs all procedures under the direct supervision of credentialed senior residents or attending physicians.

Interact with specialist and consultants in managing complex patients.

Attend weekly peripheral smear rounds conducted by an hematologist as well as ECG and X-ray conferences that are part of the noon conference series.

Rotational evaluation by ward team teaching attending.

Evaluation by senior resident.

Quarterly/Mid year evaluation by advisor/PD

Annual bed-side evaluation of history and physical examination skills.

Evaluation at focused physical examination sessions (PERK) Program.

Periodic Chart review and chart audits for documentation and accuracy of orders.

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

Demonstrates knowledge of basic and clinical sciences.

Has a good understanding of the patho-physiology of disease and disease mechanisms.

Applies knowledge to therapy

Teaching rounds of at least 4.5 hours of direct contact per week with a board certified teaching ward team attending during medical ward rotations.

!.5 hours of direct contact with teaching attending on post-call rounds each week during ward rotations.

Mandatory participation at Morning report, noon conference.

Prepare and participate at the patho-physiology club conference series conducted twice monthly.

Rotational evaluation by ward team teaching attending.

Conference attendance statistics.

Quarterly/Mid year evaluation by advisor/PD

Performance at monthly in-service examination.

Interpersonal and Communication Skills

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

Demonstrates caring and respectful behaviors with patients and families.

Uses effective listening, narrative and non-verbal skills to elicit and provide information.

Works effectively as a member of the health care team.

Workshop on communication skills that is conducted as part of the multi-disciplinary medicine course including topics such as delivering bad news, conducting a family conference and managing upset/angry patients.

Interact with patients, families during admission and follow-up care of patients.

Interact with other ward team members, attending physicians, consultants and ancillary staff.

Rotational evaluation by ward team teaching attending.

Conference attendance statistics.

Evaluation by senior resident.

Quarterly/Mid year evaluation by advisor/PD

Bed-side clinical skill assessment.

Objective Structured Clinical Exercise (OSCE) and video taped assessment of communication skills using standardized patients.

Professionalism

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

Establishes trust with patients and staff

Does not refuse to treat patients

Is honest, reliable, cooperative and accepts responsibility

Shows regard for opinions and skills of colleagues

Demonstrates respect, compassion and integrity.

Is responsive to the needs of patients and society, which supercede self-interest.

Is free from substance abuse or satisfactorily undergoing rehabilitation

Lectures, conferences and workshops on medical ethics, end of life care and professionalism that are conducted as part of the multi-disciplinary medicine course.

Residents are required to discuss end of life decision making, DNR requests with patients and family members at time of admission.

Rotational evaluation by ward team teaching attending.

Conference attendance statistics.

Evaluation by senior resident.

Quarterly/Mid year evaluation by advisor/PD

Bed-side clinical skill assessment.

Objective Structured Clinical Exercise (OSCE) and video taped assessment of communication skills using standardized patients.

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

Uses written and electronic reference and literature sources to learn about patients' diseases

Understands his or her limitations of knowledge

Asks for help when needed

Is self motivated to acquire knowledge

Uses Pubmed, Ovid and other computerized sources of results and information to enhance patient care

Accepts feedback and develops self-improvement plans.

Lectures and workshops of clinical epidemiology, biostatistics and evidence based medicine that are presented during the multi-disciplinary medicine course.

Develop a presentation of a critically appraised clinical topic (CAT) as part of an evidence based medicine project during the multi-disciplinary medicine course.

Participate in monthly journal club conference.

Develop and present abstracts, posters and oral presentations based on interesting case reports and clinical research projects.

Rotational evaluation by ward team teaching attending.

Conference attendance statistics.

Evaluation by senior resident.

Quarterly/Mid year evaluation by advisor/PD

Evaluation of the MDM presentation at the end of the rotation by at least 3 faculty members.

Presentations at institutional research events such as the Annual Sinai-Grace Hospital, Research day

Presentation of posters and oral presentations at regional and national meeting of professional organizations such as the ACP

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

Knowledgeable on clinical pathways and guidelines to provide cost effective patient care.

Is a patient advocate

Has constructive skepticism

Advocates for high quality patient care and assists patients in dealing with system complexity.

Lean about the services available at long tem care facilities, sub-acute rehabilitation units and nursing homes to arrange transfer of patients to such facilities when in-patient care is completed.

Utilized support services such as social workers and practice support nurses to expedite patient care.

Has the knowledge and capable of incorporating home care services to expedite and improve patient care.

Aware of the indication and cost of expensive diagnostics tests and uses such tests judiciously.

Understand the current health care system in the US and the extent of coverage under programs such as medicare, medicaide, managed care and third party fee for service system.

Know the cost of medications, formulary coverage and restrictions under managed care

Programs and availability of prescription assistance programs.

A practice support nurse rounds with each ward team and helps in coordinating referral to out-patient services and home care services as well as transfer to long-term care facilities, rehab and nursing homes when clinically appropriate.

Lectures on managed care, utilization review, clinical guidelines and cost of care provided during the multi-disciplinary medicine course.

Interact with social workers, discharge planners and other support personnel as part of the ward team experience.

Rotational evaluation by ward team teaching attending.

Conference attendance statistics.

Evaluation by senior resident.

Quarterly/Mid year evaluation by advisor/PD