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

Learner based learning

Provide residents with an understanding of the social impact of critical illness and the contribution of patient behavior to these problems.

Interact with families of patients who are critically ill

Effectively evaluate and manage patients with acute chest pain syndromes using appropriate diagnostic strategies.

Understand the appropriateness of various diagnostic cardiac tests including; treadmill exercise testing, dobutamine stress testing, echocardiography, diagnostic and therapeutic cardiac catheterization, nuclear stress testing and electrocardiography.

Evaluate and manage patients with acute cardiac conditions including: acute coronary syndromes, acute myocardial infarction, pulmonary edema, decompensated heart failure, valvular heart disease and pericardial tamponade.

Evaluate and manage patients who have undergone catheter based intervention procedures including: percutaneous coronary angioplasty, stent placement.

Evaluate and manage patients with chest pain of initial unknown etiology, including the analysis of cardiac markers, routine cardiac enzymes and troponin, using appropriate diagnostic testing and evaluation.

1. Monthly rotation evaluation by attending
2. Procedure logs
3. Mini-CEX (ABIM)#
4. 360-degree survey*
5. PERKS – Evaluated at the end of each session - OSCE
6. Annual bed side exam
7. Quarterly evaluation with the advisor

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. Commitment to continuous learning
3. Develop comprehensive understanding of complex medical problems
4. Demonstrate analytical thinking

Assess and evaluate current medical literature, using evidence-based principles, related to coronary artery disease, heart failure, valvular heart disease, and common cardiac arrhythmias.

Assess and evaluate current medical literature, using evidence-based principles, related to acute cardiac care.

Understand issues relating to anticoagulation in the cardiac patient including antiplatelet therapy and mechanisms of action.

Critically evaluate hemodynamic monitoring and measurements made at the bedside.

1. Monthly exam for all house staff
2. Pre and post test prior to monthly subspecialty rotations
3. Monthly PERKS program - OSCE
4. Evaluation of MDM course
5. In-Training exam
6. Monthly rotation evaluation by attending
7. Quarterly evaluation with the advisor

Interpersonal and Communication Skills

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

1. Communicate effectively with attending faculty
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. Post call and management rounds by the rounder
2. Annual bed side exam
3. ED rotation with the attending
4. Interns annual workshop
5. MDM course
6. PERKS program - OSCE
7. Oral/Poster presentation and discussion
8. Peer-group discussion
9. CD-ROM (Buckman)

1. Monthly evaluations
2. Mini-CEX (ABIM)
3. PERKS program – OSCE
4. Chart audits by faculty and CMR
5. 360-degree survey*
6. PERKS program - OSCE
7. Quarterly evaluation with the advisor

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. MDM course
2. Noon lectures by faculty
3. ABIM case modules – Done during MDM course
4. Daily interaction with health care professionals
5. Peer-group discussion
6. Faculty Role modeling

1. Monthly rotation evaluation by attending
2. ABIM Praise Cards and Early warning Cards
3. Quarterly Advisor/Advisee meeting
4. Mini-CEX (ABIM)#
5. 360-degree survey*
6. Quarterly evaluation with the advisor

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
5. Facilitate learning of others

1. Ambulatory lectures
2. Daily Clinical questions and 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 OHEP research day, annual Departmental research day
4. Awards at several scientific meetings
5. Periodic chart audit for compliance with current guidelines and compare to NCQA benchmarks
6. Periodic chart audit for LOS and UR by the floor medical Director
7. 360-degree survey*
8. Quarterly evaluation with the advisor

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
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

1. Daily interaction with nurse care coordinator
2. Multidisciplinary health care team rounds
3. MDM course
4. Net learning
5. Medical Errors – Workshop
6. M & M conference
7. Noon lectures by faculty on the following topics:

§         Introduction to Managed Care

§         Insurances

§         Negotiating Managed Care Contracts

§         Economics of Managed Care Contracts

1. Monthly rotation evaluation by attending
2. Daily rounds by the Medical Director of the floor
3. Weekly Interdisciplinary case conference
4. Quarterly evaluation with the advisor