AAAAI Modules

Resources Relevant to the Implementation
of Core ACGME-Required Competencies

Module V
Patient care
Module overview

Competency

The ACGME’s Program Requirements for Residency Education in Allergy and Immunology define the competency of patient care as care, “that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.”

The ACGME further defines a set of Allergy and immunology-specific competencies. These competencies are subsets of the core competencies and as such, may be considered embedded in them. The A/I-specific competencies that may relate to patient care include the requirements to:
• “Conduct a comprehensive and detailed medical interview with children and adults who present with suspected allergic and/or immunologic disorders.
• Perform a physical examination appropriate to the specialty
• Select, perform, and interpret diagnostic tests or studies
• Assess the risks and benefits of therapies for allergic and immunologic disorders (e.g.: drug therapy, allergen immunotherapy, immunomodulatory therapy)
• Counsel and educate patients about diagnosis, prognosis, and treatment
• Consult with and educate other physicians and health care providers.”

The Quadrad Report further amplifies the competency of patient care by listing required skills, example components, and evaluation methods, as follows:

Required Skill	Example Components	Evaluation Method
Caring and respectful behavior	Provide care that is sensitive to each patient’s age, gender, cultural, economic, and social circumstances	Patient satisfaction questionnaire OR 360 Global rating evaluation
Interviewing	Obtain a complete environmental and/or occupational history	Checklist evaluation of live-recorded performance OR Chart stimulated recall
Informed decision-making	Synthesize clinical history, physical examination findings, and laboratory results to arrive at a correct diagnosis	Chart stimulated recall OR Checklist evaluation of live/recorded performance
Develop and carry out patient management plans	Provide written action plan for management of asthma of varying severity	Chart stimulated recall OR Record review OR Allergy-immunology in-service exam OR Oral examination
Counsel and educate patients and families	Provide information necessary to understand asthma pathophysiology and treatment, including technique of medication administration and emergency care	Patient satisfaction questionnaire OR Checklist evaluation
Perform medical procedures	Perform puncture and intradermal allergy skin testing; specific allergen immunotherapy; drug desensitization; pulmonary function testing; IVIG therapy	Procedure or case logs
Preventive health services	Advise asthmatic patients to receive annual influenza immunizations; immunizations for immunocompromised patients	Record review

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Goals & objectives

The following goals and objectives for patient care have been articulated by A/I training program directors:

I. Provides compassionate care as demonstrated by sensitivity and attentiveness to patient needs and preferences
     A. May include such behavior as recognizing important life
    changes and circumstances

II. Furnishes appropriate care as evidenced by:
     A. acquisition of accurate and essential information
     such as assessing environmental factors and control
     B. utilization of appropriate differential diagnosis
     C. use and effective performance of appropriate diagnostic
    testing
     D. following practice guidelines

III. Provides effective care as evidenced by:
     A. achieving improvement in health
     for example, most patients, most of the time, improve - such as
     improvement on pulmonary function tests
     B. providing or facilitating preventive care
     for example, recommending flu shots

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