Curriculum for outcomes-based Patient Care
(one of the ACGME six general competencies):
(updated 2/1/04 by James Hellerman, MD)
Outline
I. Nuts and Bolts (or Introduction)
II. Measurable Goals & Objectives ("Outcomes")
III. Teaching Methods ("How you will learn")
IV. Outcome Assessment and Feedback
I. Nuts and Bolts (or Introduction)
Within the domain of Patient Care, the ABIM includes:
- Interviewing
- Physical Examination
- Procedures
- Clinical Judgment (ACGME)
A. Key Faculty
Interpretation of X-rays: Radiology staff
Pulmonary staff
GI staff
Neurology staff
Interpretation of EKGs: Cardiology staff
ICU staff
CMRs
Procedural Skills: ICU staff
Physical Exam: All faculty
Interviewing: See Interpersonal and
B. Patient Care will be taught by floor teaching attendings,
clinic preceptors. Residents will also have prescribed
independent study activities.
II. Measurable Goals and Objectives for Patient Care
A. Outcomes required to document competency
The fundamental goals of this curriculum are for residents
to
[ ] gather and interpret data relevant to the care of the
patient
[ ] perform and interpret the physical examination
[ ] perform and interpret appropriate procedures
[ ] interpret
[ ] laboratory test results
[ ] EKGs
[ ] radiographic studies
Residents are expected to be able to
[ ] minimize patient discomfort
[ ] maintain patients’ rights and dignity
[ ] use clinical reasoning and clinical judgment
to effect a management plan for the patient
[ ] follow appropriate guidelines to promote patient
health
The paragraphs below describe the knowledge,
skills, attitudes, and habits that residents will
demonstrate to indicate competency at each level of
training. Such competency progresses from "knowing" to
"knowing how" to “can teach”.
B. Demonstrate the following:
Knowledge and/or Skills
PGY-1
- gather patient data from all relevant sources
- perform and interpret the physical examination
- perform basic procedures and interpret data
- interpret laboratory tests
- interpret basic radiographic studies
(CXR, KUB)
- interpret basic EKGs, stress tests, ECHOs
- counsel and perform health maintenance activities
- maintain patient’s comfort, dignity, confidentiality,
safety, and rights
PGY-2 will also
- enhance data gathering and physical examination skills
- perform more advanced procedures
- interpret more complex radiographic studies
- interpret more complex EKGs
- counsel and perform health maintenance activities
PGY-3 will also
- acquire the ability to function as consultant
III. Teaching Methods and How You Will Learn
Residents will acquire the above knowledge, skills,
attitudes and habits by utilizing the following:
Videos/DVDs:
F. Daniel Duffy “Counseling for Behavior Change”
e.g. smoking cessation (ACP-ASIM)
Dr. Humboe’s Yale Observation tapes with
Dr. Dharapak
Reading: Chapter 1 and 2 in “Bates’ Guide to Physical
Examination and History Taking” 8th ed by
Lynn Bickley as well as rest of text and
Accompanying video.
Radiology Curriculum
Cardiology Curriculum
Conferences:
Physical Examination Noontime Conference Series
Radiology Noontime Conference Series
EKG Noontime Conference Series
Experiences:
Clinic, Hospital observation of Faculty
PGY-1 participate in OSCE with “standardized
resident” to counsel on:
Smoking Cessation
Weight management
Diabetes control
Fatigue/Depression
PGY-2 function as “standardized residents”
PGY-3 and CMRs record and review
Vignettes: planned for future
IV. Outcome Assessment and Feedback
Competency at each level of training in this
discipline will be documented by the resident by
means of the following:
Knowledge/Skills:
PGY-1 Quiz or paper on Practice Guidelines
PGY-2 Quiz or paper on Counseling
PGY-3 Quiz or paper on Problem Patient
Review of “Counseling for Behavior
Change” and “Efficiency Through
Effective Communication”
ABIM Global Rating Scale
Skills: Direct Observation:
mini-CEX
Standardized Resident
Nursing, NF, CMR, evaluations
ABIM Global Rating Scale
Portfolio
Residents must also provide anonymous evaluation
and feedback of this aspect of the curriculum by using this
Link.