Definitions and Competencies for Practice-based Learning and Improvement

Abstract

The Outcome Project is a long-term initiative by which the Accreditation Council for Graduate Medical Education (ACGME) is increasing emphasis on educational outcomes in the evaluation of residency programs. The ACGME initiated the Outcome Project to "ensure and improve the quality of graduate medical education." In order to assist program directors in emergency medicine (EM) to begin complying with components of the ACGME Outcome Project, the Council of Residency Directors in Emergency Medicine (CORD-EM) convened a consensus conference in March 2002 in conjunction with several other EM organizations. The working group for the competency of Practice-based Learning and Improvement (PBL) defined the components of PBL as: 1) analyze and assess practice experience and perform practice-based improvement; 2) locate, appraise, and utilize scientific evidence related to the patient's health problems and the larger population from which they are drawn; 3) apply knowledge of study design and statistical methods to critically appraise the medical literature; 4) utilize information technology to enhance personal education and improve patient care; and 5) facilitate the learning of students, colleagues, and other health care professionals in EM principles and practice. Establishing resident portfolios is a preferred method to chronicle resident competence in PBL. Traditional global evaluation of resident performance is de-emphasized. Checklist evaluation is appropriate for assessing any competency that can be broken down into specific behaviors or actions. 360-degree evaluation may be used to assess teamwork, communication skills, management skills, and clinical decision making. Chart-stimulated recall and record review are additional evaluation methods that can be used to assess resident competency in PBL. Simulations and models, such as computer-based scenarios, may be ideal for low-frequency but critical procedures.

Outcome Assessment in Emergency Medicine—A Beginning: Results of the Council of Emergency Medicine Residency Directors (CORD) Emergency Medicine Consensus Workgroup on Outcome Assessment

“…Each workgroup leader agreed to utilize the framework developed by the 2002 CORD Consensus Conference, in which the specifics of EM competency were defined. [3][4][5][6][7][8] Five of the six competencies were selected for group work. The medical knowledge competency was not addressed because it is defined as a knowledge-based competency, and two excellent outcome measures, the board examination and the in-service training examination, already exist and are used extensively by program directors.…”

“…The EM competencies were developed during a 2002 EM educator consensus conference and were disseminated that year in a series of six articles. [3][4][5][6][7][8] Residencies were expected to incorporate the teaching and learning of these EM-specific competencies into their didactic and clinical curriculum.…”

Designing Assessment Programmes for the Model Curriculum for Emergency Medicine Specialists

“…Although it is beyond the scope of this paper to describe the utility of these methods in detail, a summary of the utility of some the assessment methods described above is presented in the supplementary online appendices (Appendices 8-10). In addition, several excellent reviews currently exist which describe the utility of these assessment methods in general postgraduate training 8,9,[25][26][27] and with reference to the ACGME 21,22,[28][29][30][31][32][33] and CanMEDS framework 10,23 .…”

Academic Pharmacy's Role in Advancing Practice and Assuring Quality in Experiential Education: Report of the 2003–2004 Professional Affairs Committee

“…[35][36][37] A well-designed portfolio-based assessment system is an integrated, holis-tic approach to validating student performance and assuring competence. An attractive feature of using portfolios to document and assess student performance is that it includes a breadth of evidence related to a variety of experiences and takes into account multiple perspectives.…”