A Continuum of Competency Assessment: The Potential for Reciprocal Use of the Accreditation Council for Graduate Medical Education Toolbox and the Components of the American Board of Pediatrics Maintenance-of-Certification Program

Abstract

Reduction of unexplained variation in medical practice and health outcomes is of paramount importance, which indicates a need for a continuum of medical learning that begins in medical school and continues until the end of a professional career. That, in turn, indicates need for continuing assessment of professional competence. The American Board of Pediatrics, the American Academy of Pediatrics, and the Accreditation Council for Graduate Medical Education are working together to develop a common approach to documenting acquisition of competence during residency and maintenance of competence thereafter. A common approach will eliminate redundancy and make it possible to follow the evolution of professional competence over time. Pediatrics 2009;123:S56-S58

Linking Process to Outcome: Are We Training Pediatricians to Meet Evolving Health Care Needs?

“…Residency has an important role to fulfill, but the health of children, adolescents, and young adults depends on a combination of medical school education, focused residency education, and, perhaps most important, reflective, collaborative practice supplemented by a rigorous, focused maintenance-of-certification program. 18,57 No one of those can compensate for the absence of the other; each must be present in full measure to improve health outcomes.…”

“…These issues are developed further in the article that examines maintenance of certification as a tool for lifelong learning and reflective self-evaluation. 18 …”

“…Residency has an important role to fulfill, but the health of children, adolescents, and young adults depends on a combination of medical school education, focused residency education, and, perhaps most important, reflective, collaborative practice supplemented by a rigorous, focused maintenance-of-certification program. 18,57 No one of those can compensate for the absence of the other; each must be present in full measure to improve health outcomes.Fourth, the theme that is the subtext for the other 3 and for all discussions during this project: pediatric residency education will not achieve its potential unless it occurs in an environment committed to principles enunciated by the Institute of Medicine in Health Professions Education: A Bridge to Quality, 58 summarized briefly as a provision of patient-centered care by interdisciplinary teams with practice rooted in evidence and in the use of informatics and other techniques to make constant improvements in quality.Ongoing changes in pediatric health care require a flexible concept of residency education that can adapt to whatever the future holds, which means that both learning and learning about learning must never stop. Stated succinctly, that is the lesson of the R 3 P Project.…”

“…Completion of what is intended to be only the first phase of an ongoing effort is anticipated in early 2009. In addition to this introductory article, the supplement consists of an article that provides historical context for the R 3 P Project, 9 articles that summarize each of the colloquia, [10][11][12] and articles that describe results of the surveys requested by the R 3 P Committee and Project Group, [13][14][15][16] along with a commentary, 17 an article that describes the likely consequences of maintenance of certification on residency education, 18 and an article that projects the likely long-term future of evolutionary change in pediatric graduate medical education. 19 The colloquium summaries document a dramatic change in thinking that occurred during the course of the project.…”

Looking to the Future

“…Better-integrated and continuous learning, with a seamless transition from medical school and residency education in a competency-based system to a competency-based certification process using similar measurement tools. 6 5. Sustained innovation with a centralized entity to support and facilitate innovation and assist with the dissemination of results.…”