Designing and Developing Competency-Based Curriculum and Evaluations Benjamin Diaczok, MD St. Joseph Mercy Oakland Diane Levine, MD Wayne State University Detroit Medical Center
Educational Goals: What is a curriculum What are the components of a curriculum What resources are available to develop a curriculum How do I structure my curriculum to be ACGME compliant Recognize linkage of Milestones, Curriculum and evaluations
What is a Curriculum? Kerr defines curriculum as, "All the learning which is planned and guided by the school, whether it is carried on in groups or individually, inside or outside of school." [5] Braslavsky states that curriculum is an agreement among communities, educational professionals, and the State on what learners should take on during specific periods of their lives. Furthermore, the curriculum defines "why, what, when, where, how, and with whom to learn." [7] 5) Kelly, A. V. (2009). The curriculum: Theory and practice (pp. 1 55). Newbury Park, CA: Sage. 6) Braslavsky, C. (2003). The curriculum
Components of a Curriculum Why do I need to learn this? When and Where do I go? Who will teach me? What will I learn? How will you teach me? Will you evaluate me? What should I read?
Who will teach me? Subspecialty Education Coordinator Board certified in specialty go to person for problems Division head, PD of fellowship, designated faculty Faculty ACGME specifies PD (YOU) choose faculty Based on annual evaluations
What will I learn? What keep Program Directors up at night. May resources available: ACMGE AAIM ABIM / ABMS Certifying Body ACP Professional Organization
ACGME ABIM ABMS ACP AAIM We improve health care by assessing and advancing the quality of resident physicians education through the accreditation process. To enhance the quality of health care by certifying internists and sub-specialists who demon-strate the knowledge, skills and attitudes essential for excellent Patient care. To enhance the quality and effectiveness of health care by fostering excellence and professionalism in the practice of medicine The Alliance empowers academic internal medicine professionals and enhances health care through profes-sional development, research, and advocacy. Rules for running a program. What the institution and program are required to provide residents. Helps with service vs education issues Determines standards to become certified i.e. what classes do I need to take to graduate Oversees certification exam Defines excellence in practice. Provides liaison for PD and ACGME. Meetings inform PD of developments in education Venue for networking INSTITUTIONAL: Food, library, classrooms COMMON: Duty hours, curriculum Does not specify content of required classes Certification exam Clinical guidelines MKSAP / Board review ITE (In Training Exam) Faculty development Program resources PROGRAM SPECIFIC: Cap on admissions
The curriculum must contain the following educational components: 1. Overall educational goals for the program, which the program must distribute to residents and faculty annually; 2. Competency-based goals and objectives for each assignment at each educational level, which the program must distribute to residents and faculty annually, in either written or electronic form. These should reviewed by the resident at the start of each rotation. For each rotation or major learning experience, the written curriculum: a) should include the educational purpose; teaching methods; the mix of diseases, patient characteristics, and types of clinical encounters, procedures, and services; reading lists, pathological material, and other educational resources to be used; and a method of evaluation of resident competence; b) must define the level of residents' supervision by faculty members in all patient-care activities; and, c) should be reviewed and revised at least every 3 years by faculty members and residents to keep it current and relevant.
1. Gathers and synthesizes essential and accurate information to define each patient s clinical problem(s). (PC1) Critical Deficiencies Does not collect accurate historical data Does not use physical exam to confirm history Relies exclusively on documentation of others to generate own database or differential diagnosis Fails to recognize patient s central clinical problems Fails to recognize potentially life threatening problems Inconsistently able to acquire accurate historical information in an organized fashion Does not perform an appropriately thorough physical exam or misses key physical exam findings Does not seek or is overly reliant on secondary data Inconsistently recognizes patients central clinical problem or develops limited differential diagnoses Consistently acquires accurate and relevant histories from patients Seeks and obtains data from secondary sources when needed Consistently performs accurate and appropriately thorough physical exams Uses collected data to define a patient s central clinical problem(s) Ready for unsupervised practice Acquires accurate histories from patients in an efficient, prioritized, and hypothesisdriven fashion Performs accurate physical exams that are targeted to the patient s complaints Synthesizes data to generate a prioritized differential diagnosis and problem list Effectively uses history and physical examination skills to minimize the need for further diagnostic testing Aspirational Obtains relevant historical subtleties, including sensitive information that informs the differential diagnosis Identifies subtle or unusual physical exam findings Efficiently utilizes all sources of secondary data to inform differential diagnosis Role models and teaches the effective use of history and physical examination skills to minimize the need for further diagnostic testing Comments:
Resident Education Milestones Curriculum Evaluation