AAAAI Modules

Resources Relevant to the Implementation
of Core ACGME-Required Competencies

Module II
Practice-based learning & improvement
Module overview

Competency

The ACGME’s Program Requirements for Residency Education in Allergy and Immunology define the competency of practice-based learning and improvement as, “involving investigation and evaluation of [one’s] own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care.”

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 practice-based learning and improvement include the requirements to:

• “Assess the risks and benefits of therapies for allergic and immunologic disorders (e.g.: drug therapy, allergen immunotherapy, immunomodulatory therapy)
• Consult with and educate other physicians and health care providers
• Coordinate the care of patients, including the use of consultation
• Analyze medical and other scientific literature.”

The ACGME also defines a set of personal and professional competencies. These competencies are subsets of the core competencies and as such, may be considered embedded in them. The personal and professional competencies that may be related to practice-based learning and improvement include the requirement to:

• “demonstrate acceptance of the need for a lifelong pursuit of excellence, self-directed learning, and continuing education.”

The Quadrad Report further amplifies the competency of practice-based learning and improvement by listing required skills, example components, and evaluation methods, as follows:

Required Skill	Example Components	Evaluation Method
Analyze own practice for needed improvement	Use evaluations of performance provided by 360 global rating evaluations to improve practice	Patient portfolios OR Continuity care clinic records
Use of evidence from scientific studies	Incorporate new pharmacologic agents and treatment programs into clinical practice	Chart stimulated recall OR Record review OR Multiple choice written exam OR Oral exam
Application of research and statistical methods	Critically review published medical literature at journal clubs	Research protocols OR Allergy-immunology in-service exam
Use of information technology	Use Medline or other database for information to improve patient care or teaching	Patient portfolios OR Preparation and presentation of conferences
Facilitate learning of others	Teach medical students, residents, and other health professionals	360 Global rating evaluation OR Evaluation of teaching conferences

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Goals & objectives

The following goals and objectives for practice-based learning and improvement have been articulated by A/I training program directors:

I. Analyzes own practice for needed improvement
     A. for example, through chart audit of a sample of patients with a particular diagnosis, for completeness and application of guidelines

II. Uses evidence from scientific studies
     A. for example, as demonstrated by a literature review of a disease process or a therapeutic intervention based on a patient case
     B. for example, using evidence to maintain or change practice

III. Applies research and statistical methods by demonstrating comprehension of clinical study design and application of biostatistics to clinical studies
     A. for example, through presentations and critical evaluations of study design and validity of conclusions

IV. Uses information technology appropriately and competently as evidenced by finding and retrieving relevant information
     A. for example, PubMed and Cochrane Database

V. Facilitates learning of health care professionals and the public
      A. for example, as demonstrated by feedback indicative of effective teaching, whether formal or informal.

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