Resources Relevant to the Implementation
of Core ACGME-Required Competencies


Module IV
    Professionalism
          Example




Example
      
This module contains a large number of resources and materials. Training programs will vary considerably in the type and number of resources they choose to use. There is no one best way in which to use the materials contained in this module.

As programs become familiar with the materials, it is likely that they will adapt resource use to align with specific program needs and abilities. To begin, it may be useful to have an example of a way in which to use the materials.

This approach is not meant to prescribe what one should do but is meant to provide a comprehensive example of what one could do with these materials to meet the ACGME mandates. What follows is a description or example of how one actual program director might choose to use these materials.

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Step 1: The program director meets with new fellows to discuss the role of the ACGME competencies in the training program.

Step 2: The program director meets with other GME program directors to consider curricular overlaps.

In this example, the GME program directors decide to work together on a monthly Brown Bag series that will address issues related to the core competencies. Twice yearly, the competency addressed will be professionalism.

Step 3: The program director introduces fellows to the assessment tools selected for use by the program. In this example, the adapted ABIM questions, the SEGUE Framework, the professional associate rating form, and the Physicianship Evaluation Form have been selected for use.

Portfolios, although not particularly appropriate for assessing professionalism, are excellent tools for documenting the creation and use of a learning plan. With this use in mind, portfolios are begun by having fellows create a learning plan, including goals and objectives, for some discrete period of time.

In this example, the time period is six months.

As an example, one fellow might identify learning goals related to the provision of culturally sensitive care while another fellow might identify learning goals related to ethics.

Step 4. Fellows are expected to understand the concepts embedded in professionalism. In this example, resources from the ABIM’s Project Professionalism are used. Fellows may choose to focus on one or more topics as a springboard for discussion or may choose to work through some of the professionalism vignettes.
Resource use is documented in the learning plan.

Step 5: Fellows in this program are expected to “
design, conduct, write, and present research in either laboratory-based or clinical investigation in allergy and/or immunology.“* (ACGME’s Program Requirements for Residency Education in Allergy and Immunology) To prepare for this, the training program points fellows to resources such as the SUNY Health Sciences Evidence-based Medicine Course. Resource use, results, and reflection are documented in the portfolio.

Step 6: Fellows may use case discussion, such as managed care case studies to explore the issue of managed care ethics. Resource use, results, and reflection are documented in the portfolio.

Step 7: In this example, many of the patients encountered are recent immigrants from Mexico. Fellows are encouraged to learn about the culture and health beliefs of these patients. Resource use, learning, and reflection are documented in the portfolio.

Step 8: Every six months, two unannounced observations of patient encounters are carried out by faculty for each fellow. The SEGUE Framework is used as an assessment tool. Results are documented.

Step 9: Patient surveys are collected for each fellow one week (or until 20 patients have completed surveys) every six months. Results are tallied and documented.

Step 10: Professional associate rating forms are collected for each fellow every six months. Results are tallied and documented.

Step 11: Throughout each six month time period, fellows document experiences in their portfolios that align with their learning plan.

Step 12: The program director meets with each fellow every six months to provide feedback from all assessment tools noted above as well as other sources of information.

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