Sample records for acgme general competencies

  1. Can One Portfolio Measure the Six ACGME General Competencies?

    ERIC Educational Resources Information Center

    Jarvis, Robert M.; O'Sullivan, Patricia S.; McClain, Tina; Clardy, James A.

    2004-01-01

    Objective: To determine that portfolios, useable by any program, can provide needed evidence of resident performance within the ACGME general competencies. Methods: Eighteen residents constructed portfolios with selected entries from thirteen psychiatric skills. Two raters assessed whether entries reflected resident performance within the general…

  2. An Overview of Cultural Competency Curricula in ACGME-accredited General Surgery Residency Programs.

    PubMed

    Shah, Sagar S; Sapigao, Francisco B; Chun, Maria B J

    Cultural competency(CC) in surgical residency curricula is not the novel idea it was fourteen years ago when the ACGME challenged program directors to teach and assess six core competencies. CC is recognized as a component of "patient care", "professionalism", and "interpersonal and communication skills." The results of five programs (2004-2012) with CC curricula were identified in a 2013 paper by Ly and Chun. The primary objective of this paper is to provide the current status of CC curricula in general surgery residency programs. Three sources were used for this study. First, a four question survey on the current status of CC education was sent to program directors of ACGME-accredited surgery residency programs. Second, the lead authors from five programs previously reported in the 2013 paper were interviewed. Third, the survey mentioned above was resent to 52 residency programs who implemented New York University's (NYU) SPICE program, which has a CC component. Participants for the survey consisted of program directors of ACGME-accredited surgery residency programs. The interviews were conducted with the corresponding authors from the previous study by Ly and Chun. Of the 256 surveyed, nine responded; seven stated that CC is not taught formally at their institution while four stated that they do not feel any part of CC curricula is missing from their program. Due to the low response rate, we identified and conducted interviews with general surgery residency programs with CC curricula. Of the five programs contacted, only three remain active and utilize Objective Structured Clinical Examinations (OSCEs) to teach cultural competency. One of the three, the SPICE program at NYU, has expanded to 52 other residency programs in the US. Although the importance of CC has been identified in general surgery, formal curricula and documentation of implementation remains elusive. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All

  3. Duty Hour Recommendations and Implications for Meeting the ACGME Core Competencies: Views of Residency Directors

    PubMed Central

    Antiel, Ryan M.; Thompson, Scott M.; Hafferty, Frederic W.; James, Katherine M.; Tilburt, Jon C.; Bannon, Michael P.; Fischer, Philip R.; Farley, David R.; Reed, Darcy A.

    2011-01-01

    OBJECTIVE: To describe the views of residency program directors regarding the effect of the 2010 duty hour recommendations on the 6 core competencies of graduate medical education. METHODS: US residency program directors in internal medicine, pediatrics, and general surgery were e-mailed a survey from July 8 through July 20, 2010, after the 2010 Accreditation Council for Graduate Medical Education (ACGME) duty hour recommendations were published. Directors were asked to rate the implications of the new recommendations for the 6 ACGME core competencies as well as for continuity of inpatient care and resident fatigue. RESULTS: Of 719 eligible program directors, 464 (65%) responded. Most program directors believe that the new ACGME recommendations will decrease residents' continuity with hospitalized patients (404/464 [87%]) and will not change (303/464 [65%]) or will increase (26/464 [6%]) resident fatigue. Additionally, most program directors (249-363/464 [53%-78%]) believe that the new duty hour restrictions will decrease residents' ability to develop competency in 5 of the 6 core areas. Surgery directors were more likely than internal medicine directors to believe that the ACGME recommendations will decrease residents' competency in patient care (odds ratio [OR], 3.9; 95% confidence interval [CI], 2.5-6.3), medical knowledge (OR, 1.9; 95% CI, 1.2-3.2), practice-based learning and improvement (OR, 2.7; 95% CI, 1.7-4.4), interpersonal and communication skills (OR, 1.9; 95% CI, 1.2-3.0), and professionalism (OR, 2.5; 95% CI, 1.5-4.0). CONCLUSION: Residency program directors' reactions to ACGME duty hour recommendations demonstrate a marked degree of concern about educating a competent generation of future physicians in the face of increasing duty hour standards and regulation. PMID:21307391

  4. Assessing the ACGME Competencies in Psychiatry Training Programs

    ERIC Educational Resources Information Center

    Swick, Susan; Hall, Sarah; Beresin, Eugene

    2006-01-01

    In 2000, the Accreditation Council of Graduate Medical Education (ACGME) laid out a definition of competence that included six specific areas of focus: patient care (including clinical reasoning), medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. The…

  5. Introducing practice-based learning and improvement ACGME core competencies into a family medicine residency curriculum.

    PubMed

    Coleman, Mary Thoesen; Nasraty, Soraya; Ostapchuk, Michael; Wheeler, Stephen; Looney, Stephen; Rhodes, Sandra

    2003-05-01

    The Accreditation Council for Graduate Medical Education (ACGME) recommends integrating improvement activities into residency training. A curricular change was designed at the Department of Family and Community Medicine, University of Louisville, to address selected ACGME competencies by incorporating practice-based improvement activities into the routine clinical work of family medicine residents. Teams of residents, faculty, and office staff completed clinical improvement projects at three ambulatory care training sites. Residents were given academic credit for participation in team meetings. After 6 months, residents presented results to faculty, medical students, other residents, and staff from all three training sites. Residents, staff, and faculty were recognized for their participation. Resident teams demonstrated ACGME competencies in practice-based improvement: Chart audits indicated improvement in clinical projects; quality improvement tools demonstrated analysis of root causes and understanding of the process; plan-do-study-act cycle worksheets demonstrated the change process. Improvement activities that affect patient care and demonstrate selected ACGME competencies can be successfully incorporated into the daily work of family medicine residents.

  6. Residency Programs' Evaluations of the Competencies: Data Provided to the ACGME About Types of Assessments Used by Programs

    PubMed Central

    Holt, Kathleen D.; Miller, Rebecca S.; Nasca, Thomas J.

    2010-01-01

    Background In 1999, the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project began to focus on resident performance in the 6 competencies of patient care, medical knowledge, professionalism, practice-based learning and improvement, interpersonal communication skills, and professionalism. Beginning in 2007, the ACGME began collecting information on how programs assess these competencies. This report provides information on the nature and extent of those assessments. Methods Using data collected by the ACGME for site visits, we use descriptive statistics and percentages to describe the number and type of methods and assessors accredited programs (n  =  4417) report using to assess the competencies. Observed differences among specialties, methodologies, and assessors are tested with analysis of variance procedures. Results Almost all (>97%) of programs report assessing all of the competencies and using multiple methods and multiple assessors. Similar assessment methods and evaluator types were consistently used across the 6 competencies. However, there were some differences in the use of patient and family as assessors: Primary care and ambulatory specialties used these to a greater extent than other specialties. Conclusion Residency programs are emphasizing the competencies in their evaluation of residents. Understanding the scope of evaluation methodologies that programs use in resident assessment is important for both the profession and the public, so that together we may monitor continuing improvement in US graduate medical education. PMID:22132294

  7. ACGME core competency training, mentorship, and research in surgical subspecialty fellowship programs.

    PubMed

    Francesca Monn, M; Wang, Ming-Hsien; Gilson, Marta M; Chen, Belinda; Kern, David; Gearhart, Susan L

    2013-01-01

    To determine the perceived effectiveness of surgical subspecialty training programs in teaching and assessing the 6 ACGME core competencies including research. Cross-sectional survey. ACGME approved training programs in pediatric urology and colorectal surgery. Program Directors and recent trainees (2007-2009). A total of 39 program directors (60%) and 57 trainees (64%) responded. Both program directors and recent trainees reported a higher degree of training and mentorship (75%) in patient care and medical knowledge than the other core competencies (p<0.0001). Practice based learning and improvement, interpersonal and communication, and professionalism training were perceived effective to a lesser degree. Specifically, in the areas of teaching residents and medical students and team building, program directors, compared with recent trainees, perceived training to be more effective, (p = 0.004, p = 0.04). Responses to questions assessing training in systems based practice ubiquitously identified a lack of training, particularly in financial matters of running a practice. Although effective training in research was perceived as lacking by recent trainees, 81% reported mentorship in this area. According to program directors and recent trainees, the most effective method of teaching was faculty supervision and feedback. Only 50% or less of the recent trainees reported mentorship in career planning, work-life balance, and job satisfaction. Not all 6 core competencies and research are effectively being taught in surgery subspecialty training programs and mentorship in areas outside of patient care and research is lacking. Emphasis should be placed on faculty supervision and feedback when designing methods to better incorporate all 6 core competencies, research, and mentorship. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  8. Development of an audit method to assess the prevalence of the ACGME's general competencies in an undergraduate medical education curriculum.

    PubMed

    Mooney, Christopher J; Lurie, Stephen J; Lyness, Jeffrey M; Lambert, David R; Guzick, David S

    2010-10-01

    Despite the use of competency-based frameworks to evaluate physicians, the role of competency-based objectives in undergraduate medical education remains uncertain. By use of an audit methodology, we sought to determine how the six Accreditation Council for Graduate Medical Education (ACGME) competencies, conceptualized as educational domains, would map onto an undergraduate medical curriculum. Standardized audit forms listing required activities were provided to course directors, who were then asked to indicate which of the domains were represented in each activity. Descriptive statistics were calculated. Of 1,500 activities, there was a mean of 2.13 domains per activity. Medical Knowledge was the most prevalent (44%), followed by Patient Care (20%), Interpersonal and Communication Skills (12%), Professionalism (9%), Systems-Based Practice (8%), and Practice-Based Learning and Improvement (7%). There was considerable variation by year and course. The domains provide a useful framework for organizing didactic components. Faculty can also consider activities in light of the domains, providing a vocabulary for instituting curricular change and innovation.

  9. Digital slides and ACGME resident competencies in anatomic pathology: An altered paradigm for acquisition and assessment

    PubMed Central

    Hassell, Lewis A.; Fung, Kar-Ming; Chaser, Brad

    2011-01-01

    Whole slide digital imaging technology has matured considerably over the past decade. Applications in pathology education are widespread and are rapidly transforming the manner in which medical students learn pathology and histology, and they have a novel and significant impact on postgraduate continuing medical education. Whole slide digital images for use in pathology graduate education have been slower in adoption and remain much less widespread. Emphasis on professional competency by the Accreditation Council on Graduate Medical Education (ACGME) and credentialing organizations, however, appear poised to significantly increase. The convergence of these two forces is propitious for pathology training. This article examines the opportunities for the use of whole slide images (WSI) in pathology residency training along with the developing potential uses in each of the areas of competency, as categorized by the ACGME. Barriers to WSI adoption in the pathology community are identified along with potentially significant promoters for adoption in training and practice. Current literature and recent presentations are reviewed. Digital pathology coupled with emphasis on competency is a shift of tremendous magnitude that can dramatically improve our abilities to help trainees acquire, demonstrate, and maintain the skills to practice pathology in the generation ahead. PMID:21773058

  10. Shadowing emergency medicine residents by medical education specialists to provide feedback on non-medical knowledge-based ACGME sub-competencies.

    PubMed

    Waterbrook, Anna L; Spear Ellinwood, Karen C; Pritchard, T Gail; Bertels, Karen; Johnson, Ariel C; Min, Alice; Stoneking, Lisa R

    2018-01-01

    Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management) are challenging for a supervising emergency medicine (EM) physician to evaluate in real-time on shift while also managing a busy emergency department (ED). This study examines residents' perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills. Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year. In an attempt to increase meaningful feedback to the residents, these specialists evaluated resident performance in selected non-medical knowledge-based Accreditation Council of Graduate Medical Education (ACGME) sub-competencies and provided residents with direct, real-time feedback, followed by a written evaluation sent via email. Evaluations provided specific references to examples of behaviors observed during the shift and connected these back to ACGME competencies and milestones. Twelve residents participated in this shadow experience (six post graduate year 1 and six postgraduate year 2). Two residents emailed the medical education specialists ahead of the scheduled shadow shift requesting specific feedback. When queried, five residents voluntarily requested their feedback to be included in their formal biannual review. Residents received milestone scores and narrative feedback on the non-medical knowledge-based ACGME sub-competencies and indicated the shadow experience and subsequent feedback were valuable. Medical education specialists who observe residents over the course of an entire shift and evaluate non-medical knowledge-based skills are perceived by EM residents to provide meaningful feedback and add valuable information for the biannual review process.

  11. Shadowing emergency medicine residents by medical education specialists to provide feedback on non-medical knowledge-based ACGME sub-competencies

    PubMed Central

    Waterbrook, Anna L; Spear Ellinwood, Karen C; Pritchard, T Gail; Bertels, Karen; Johnson, Ariel C; Min, Alice; Stoneking, Lisa R

    2018-01-01

    Objective Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management) are challenging for a supervising emergency medicine (EM) physician to evaluate in real-time on shift while also managing a busy emergency department (ED). This study examines residents’ perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills. Methods Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year. In an attempt to increase meaningful feedback to the residents, these specialists evaluated resident performance in selected non-medical knowledge-based Accreditation Council of Graduate Medical Education (ACGME) sub-competencies and provided residents with direct, real-time feedback, followed by a written evaluation sent via email. Evaluations provided specific references to examples of behaviors observed during the shift and connected these back to ACGME competencies and milestones. Results Twelve residents participated in this shadow experience (six post graduate year 1 and six postgraduate year 2). Two residents emailed the medical education specialists ahead of the scheduled shadow shift requesting specific feedback. When queried, five residents voluntarily requested their feedback to be included in their formal biannual review. Residents received milestone scores and narrative feedback on the non-medical knowledge-based ACGME sub-competencies and indicated the shadow experience and subsequent feedback were valuable. Conclusion Medical education specialists who observe residents over the course of an entire shift and evaluate non-medical knowledge-based skills are perceived by EM residents to provide meaningful feedback and add valuable information for the biannual review process. PMID:29765259

  12. Emotional intelligence in medicine: a systematic review through the context of the ACGME competencies.

    PubMed

    Arora, Sonal; Ashrafian, Hutan; Davis, Rachel; Athanasiou, Thanos; Darzi, Ara; Sevdalis, Nick

    2010-08-01

    Emotional intelligence (EI) involves the perception, processing, regulation and management of emotions. This article aims to systematically review the evidence for EI in medicine through the context of the Accreditation Council for Graduate Medical Education (ACGME) competencies. MEDLINE, EMBASE, PsycINFO, the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials were searched for English-language articles published between January 1980 and March 2009. The grey literature was also searched and experts in the field contacted for additional studies. Two independent reviewers selected articles which reported empirical research studies about clinicians or medical students. Conceptual articles and opinion pieces and commentaries were excluded. Information about the measure used to assess EI, the study parameter or domain, and the educational or clinical outcome (with specific relation to the ACGME competencies) was extracted. The literature search identified 485 citations. An abstract review led to the retrieval of 24 articles for full-text assessment, of which 16 articles were included in the final review. Eleven studies focused on postgraduates, four on undergraduates and one on medical school applicants. Six out of seven studies found women to have higher EI than men. Higher EI was reported to positively contribute to the doctor-patient relationship (three studies), increased empathy (five studies), teamwork and communication skills (six studies), and stress management, organisational commitment and leadership (three studies). Measures of EI correlate with many of the competencies that modern medical curricula seek to deliver. Further research is required to determine whether training can improve EI and thus augment educational and clinical outcomes.

  13. Barriers to Implementing the ACGME Outcome Project: A Systematic Review of Program Director Surveys.

    PubMed

    Malik, Mohammad U; Diaz Voss Varela, David A; Stewart, Charles M; Laeeq, Kulsoom; Yenokyan, Gayane; Francis, Howard W; Bhatti, Nasir I

    2012-12-01

    The Accreditation Council for Graduate Medical Education (ACGME) introduced the Outcome Project in July 2001 to improve the quality of resident education through competency-based learning. The purpose of this systematic review is to determine and explore the perceptions of program directors regarding challenges to implementing the ACGME Outcome Project. We used the PubMed and Web of Science databases and bibliographies for English-language articles published between January 1, 2001, and February 17, 2012. Studies were included if they described program directors' opinions on (1) barriers encountered when attempting to implement ACGME competency-based education, and (2) assessment methods that each residency program was using to implement competency-based education. Articles meeting the inclusion criteria were screened by 2 researchers. The grading criterion was created by the authors and used to assess the quality of each study. The survey-based data reported the opinions of 1076 program directors. Barriers that were encountered include: (1) lack of time; (2) lack of faculty support; (3) resistance of residents to the Outcome Project; (4) insufficient funding; (5) perceived low priority for the Outcome Project; (6) inadequate salary incentive; and (7) inadequate knowledge of the competencies. Of the 6 competencies, those pertaining to patient care and medical knowledge received the most responses from program directors and were given highest priority. The reviewed literature revealed that time and financial constraints were the most important barriers encountered when implementing the ACGME Outcome Project.

  14. Status of Competency-Based Medical Education in Endoscopy Training: A Nationwide Survey of US ACGME-Accredited Gastroenterology Training Programs.

    PubMed

    Patel, S G; Keswani, R; Elta, G; Saini, S; Menard-Katcher, P; Del Valle, J; Hosford, L; Myers, A; Ahnen, D; Schoenfeld, P; Wani, S

    2015-07-01

    The Accreditation Council for Graduate Medical Education (ACGME) emphasizes the importance of medical trainees meeting specific performance benchmarks and demonstrating readiness for unsupervised practice. The aim of this study was to examine the readiness of Gastroenterology (GI) fellowship programs for competency-based evaluation in endoscopic procedural training. ACGME-accredited GI program directors (PDs) and GI trainees nationwide completed an online survey of domains relevant to endoscopy training and competency assessment. Participants were queried about current methods and perceived quality of endoscopy training and assessment of competence. Participants were also queried about factors deemed important in endoscopy competence assessment. Five-point Likert items were analyzed as continuous variables by an independent t-test and χ(2)-test was used for comparison of proportions. Survey response rate was 64% (94/148) for PDs and 47% (546/1,167) for trainees. Twenty-three percent of surveyed PDs reported that they do not have a formal endoscopy curriculum. PDs placed less importance (1—very important to 5—very unimportant) on endoscopy volume (1.57 vs. 1.18, P<0.001), adenoma detection rate (2.00 vs. 1.53, P<0.001), and withdrawal times (1.96 vs. 1.68, P=0.009) in determining endoscopy competence compared with trainees. A majority of PDs report that competence is assessed by procedure volume (85%) and teaching attending evaluations (96%). Only a minority of programs use skills assessment tools (30%) or specific quality metrics (28%). Specific competencies are mostly assessed by individual teaching attending feedback as opposed to official documentation or feedback from a PD. PDs rate the overall quality of their endoscopy training and assessment of competence as better than overall ratings by trainees. Although the majority of PDs and trainees nationwide believe that measuring specific metrics is important in determining endoscopy competence, most programs

  15. Attitudes and Perceptions of Surgical Oncology Fellows on ACGME Accreditation and the Complex General Surgical Oncology Certification.

    PubMed

    Lee, David Y; Flaherty, Devin C; Lau, Briana J; Deutsch, Gary B; Kirchoff, Daniel D; Huynh, Kelly T; Lee, Ji-Hey; Faries, Mark B; Bilchik, Anton J

    2015-11-01

    With the first qualifying examination administered September 15, 2014, complex general surgical oncology (CGSO) is now a board-certified specialty. We aimed to assess the attitudes and perceptions of current and future surgical oncology fellows regarding the recently instituted Accreditation Council for Graduate Medical Education (ACGME) accreditation. A 29-question anonymous survey was distributed to fellows in surgical oncology fellowship programs and applicants interviewing at our fellowship program. There were 110 responses (79 fellows and 31 candidates). The response rate for the first- and second-year fellows was 66 %. Ninety-percent of the respondents were aware that completing an ACGME-accredited fellowship leads to board eligibility in CGSO. However, the majority (80 %) of the respondents stated that their decision to specialize in surgical oncology was not influenced by the ACGME accreditation. The fellows in training were concerned about the cost of the exam (90 %) and expressed anxiety in preparing for another board exam (83 %). However, the majority of the respondents believed that CGSO board certification will be helpful (79 %) in obtaining their future career goals. Interestingly, candidate fellows appeared more focused on a career in general complex surgical oncology (p = 0.004), highlighting the impact that fellowship training may have on organ-specific subspecialization. The majority of the surveyed surgical oncology fellows and candidates believe that obtaining board certification in CGSO is important and will help them pursue their career goals. However, the decision to specialize in surgical oncology does not appear to be motivated by ACGME accreditation or the new board certification.

  16. Comparing Real-time Versus Delayed Video Assessments for Evaluating ACGME Sub-competency Milestones in Simulated Patient Care Environments

    PubMed Central

    Stiegler, Marjorie; Hobbs, Gene; Martinelli, Susan M; Zvara, David; Arora, Harendra; Chen, Fei

    2018-01-01

    Background Simulation is an effective method for creating objective summative assessments of resident trainees. Real-time assessment (RTA) in simulated patient care environments is logistically challenging, especially when evaluating a large group of residents in multiple simulation scenarios. To date, there is very little data comparing RTA with delayed (hours, days, or weeks later) video-based assessment (DA) for simulation-based assessments of Accreditation Council for Graduate Medical Education (ACGME) sub-competency milestones. We hypothesized that sub-competency milestone evaluation scores obtained from DA, via audio-video recordings, are equivalent to the scores obtained from RTA. Methods Forty-one anesthesiology residents were evaluated in three separate simulated scenarios, representing different ACGME sub-competency milestones. All scenarios had one faculty member perform RTA and two additional faculty members perform DA. Subsequently, the scores generated by RTA were compared with the average scores generated by DA. Variance component analysis was conducted to assess the amount of variation in scores attributable to residents and raters. Results Paired t-tests showed no significant difference in scores between RTA and averaged DA for all cases. Cases 1, 2, and 3 showed an intraclass correlation coefficient (ICC) of 0.67, 0.85, and 0.50 for agreement between RTA scores and averaged DA scores, respectively. Analysis of variance of the scores assigned by the three raters showed a small proportion of variance attributable to raters (4% to 15%). Conclusions The results demonstrate that video-based delayed assessment is as reliable as real-time assessment, as both assessment methods yielded comparable scores. Based on a department’s needs or logistical constraints, our findings support the use of either real-time or delayed video evaluation for assessing milestones in a simulated patient care environment. PMID:29736352

  17. Family Skills for General Psychiatry Residents: Meeting ACGME Core Competency Requirements

    ERIC Educational Resources Information Center

    Berman, Ellen M.; Heru, Alison M.; Grunebaum, Henry; Rolland, John; Wood, Beatrice; Bruty, Heidi

    2006-01-01

    Objective: The authors discuss the knowledge, attitudes, and skills needed for a resident to be competent in supporting and working with families, as mandated by the residency review committee (RRC) core competencies. Methods: The RRC core competencies, as they relate to patients and their families, are reviewed. The Group for Advancement of…

  18. Association of the 2011 ACGME resident duty hour reform with general surgery patient outcomes and with resident examination performance.

    PubMed

    Rajaram, Ravi; Chung, Jeanette W; Jones, Andrew T; Cohen, Mark E; Dahlke, Allison R; Ko, Clifford Y; Tarpley, John L; Lewis, Frank R; Hoyt, David B; Bilimoria, Karl Y

    2014-12-10

    In 2011, the Accreditation Council for Graduate Medical Education (ACGME) restricted resident duty hour requirements beyond those established in 2003, leading to concerns about the effects on patient care and resident training. To determine if the 2011 ACGME duty hour reform was associated with a change in general surgery patient outcomes or in resident examination performance. Quasi-experimental study of general surgery patient outcomes 2 years before (academic years 2009-2010) and after (academic years 2012-2013) the 2011 duty hour reform. Teaching and nonteaching hospitals were compared using a difference-in-differences approach adjusted for procedural mix, patient comorbidities, and time trends. Teaching hospitals were defined based on the proportion of cases at which residents were present intraoperatively. Patients were those undergoing surgery at hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). General surgery resident performance on the annual in-training, written board, and oral board examinations was assessed for this same period. National implementation of revised resident duty hour requirements on July 1, 2011, in all ACGME accredited residency programs. Primary outcome was a composite of death or serious morbidity; secondary outcomes were other postoperative complications and resident examination performance. In the main analysis, 204,641 patients were identified from 23 teaching (n = 102,525) and 31 nonteaching (n = 102,116) hospitals. The unadjusted rate of death or serious morbidity improved during the study period in both teaching (11.6% [95% CI, 11.3%-12.0%] to 9.4% [95% CI, 9.1%-9.8%], P < .001) and nonteaching hospitals (8.7% [95% CI, 8.3%-9.0%] to 7.1% [95% CI, 6.8%-7.5%], P < .001). In adjusted analyses, the 2011 ACGME duty hour reform was not associated with a significant change in death or serious morbidity in either postreform year 1 (OR, 1.12; 95% CI, 0

  19. The ACGME case log: General surgery resident experience in pediatric surgery

    PubMed Central

    Gow, Kenneth W.; Drake, F. Thurston; Aarabi, Shahram; Waldhausen, John H.

    2014-01-01

    Background General surgery (GS) residents in ACGME programs log cases performed during their residency. We reviewed designated pediatric surgery (PS) cases to assess for changes in performed cases over time. Methods The ACGME case logs for graduating GS residents were reviewed from academic year (AY) 1989–1990 to 2010–2011 for designated pediatric cases. Overall and designated PS cases were analyzed. Data were combined into five blocks: Period I (AY1989–90 to AY1993–94), Period II (AY1994–95 to AY1998–99), Period III (AY1999–00 to AY2002–03), Period IV (AY2003–04 to AY2006–07), and Period V (AY2007–08 to AY2010–11). Periods IV and V were delineated by implementation of duty hour restrictions. Student t-tests compared averages among the time periods with significance at P < .05. Results Overall GS case load remained relatively stable. Of total cases, PS cases accounted for 5.4% in Period I and 3.7% in Period V. Designated pediatric cases declined for each period from an average of 47.7 in Period I to 33.8 in Period V. These changes are due to a decline in hernia repairs, which account for half of cases. All other cases contributed only minimally to the pediatric cases. The only laparoscopic cases in the database were anti-reflux procedures, which increased over time. Conclusions GS residents perform a diminishing number of designated PS cases. This decline occurred before the onset of work-hour restrictions. These changes have implications on the capabilities of the current graduating workforce. However, the case log does not reflect all cases trainees may be exposed to, so revision of this list is recommended. PMID:23932601

  20. Charting the Road to Competence: Developmental Milestones for Internal Medicine Residency Training

    PubMed Central

    Green, Michael L.; Aagaard, Eva M.; Caverzagie, Kelly J.; Chick, Davoren A.; Holmboe, Eric; Kane, Gregory; Smith, Cynthia D.; Iobst, William

    2009-01-01

    Background The Accreditation Council for Graduate Medical Education (ACGME) Outcome Project requires that residency program directors objectively document that their residents achieve competence in 6 general dimensions of practice. Intervention In November 2007, the American Board of Internal Medicine (ABIM) and the ACGME initiated the development of milestones for internal medicine residency training. ABIM and ACGME convened a 33-member milestones task force made up of program directors, experts in evaluation and quality, and representatives of internal medicine stakeholder organizations. This article reports on the development process and the resulting list of proposed milestones for each ACGME competency. Outcomes The task force adopted the Dreyfus model of skill acquisition as a framework the internal medicine milestones, and calibrated the milestones with the expectation that residents achieve, at a minimum, the “competency” level in the 5-step progression by the completion of residency. The task force also developed general recommendations for strategies to evaluate the milestones. Discussion The milestones resulting from this effort will promote competency-based resident education in internal medicine, and will allow program directors to track the progress of residents and inform decisions regarding promotion and readiness for independent practice. In addition, the milestones may guide curriculum development, suggest specific assessment strategies, provide benchmarks for resident self-directed assessment-seeking, and assist remediation by facilitating identification of specific deficits. Finally, by making explicit the profession's expectations for graduates and providing a degree of national standardization in evaluation, the milestones may improve public accountability for residency training. PMID:21975701

  1. Graduates' perceptions of their clinical competencies in allergy and immunology: results of a survey.

    PubMed

    Li, James T-C; Stoll, Doris A; Smith, June E; Lin, John J; Swing, Susan R

    2003-09-01

    The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS) have identified six areas of general competency. This study surveyed graduates of allergy and immunology training programs about their perceived clinical competency and the adequacy of their subspecialty training. In August 2000 and May 2001, a questionnaire was mailed to 373 physicians who had completed a fellowship in allergy and immunology in the United States between 1995 and 2001. Physicians were asked to rate the perceived importance and adequacy of their training in, and their level of competency for, 57 general competencies and subspecialty-specific competencies and procedures. A total of 253 physicians responded (68%). All items in the six ACGME/ABMS general competencies had high ratings (>/= 90%) for perceived importance. One item in the practice-based learning area had low ratings for adequacy of training (57%) and intermediate for competency (75%). Two items in the system-based practice area had low ratings for training (65% and 67%) and intermediate for competency (86% and 88%). Generally, core specialty-specific items (allergic rhinitis, asthma, and urticaria) had high ratings (>/= 90%) for importance, training, and competency. Without exception, items with ratings of less than 70% for adequacy of training also had ratings of less than 90% for competency. The general competencies were considered important, but training in system-based practice and practice-based learning may be deficient. Although self-perceived competency in core areas of allergy and immunology was high, weaknesses in training and self-perceived competency in selected areas were identified.

  2. AOA Approval of ACGME Internship and Residency Training.

    PubMed

    Duffy, Thomas; Martinez, Bulmaro

    2011-04-01

    Since the 1970s, the American Osteopathic Association (AOA) has provided a means for osteopathic physicians to apply for approval of their postdoctoral training in programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). Osteopathic physicians who trained in ACGME programs need this approval to meet AOA licensure and board certification requirements. The AOA approves ACGME residency training with several different approval processes. Approval of the first year of postdoctoral training occurs through Resolution 42, specialty approval (for specialties in which the first year of training is part of the residency), or federal or military training approval. For residency training, the AOA verifies successful completion of an ACGME training program before approving the training. The AOA is using customer surveys and online applications to improve the review process for applicants.

  3. Emotional Intelligence and the ACGME Competencies.

    PubMed

    Webb, Anita R; Young, Richard A; Baumer, Joane G

    2010-12-01

    Residency programs desire assessment tools for teaching and measuring resident attainment of the Accreditation Council for Graduate Medical Education competencies, including interpersonal and communication skills. We sought to evaluate the use of emotional intelligence (EI) assessment and training tools in assessing and enhancing interpersonal and communication skills. We used a quasi-experimental design, with an intervention and control group composed of 1 class each of family medicine residents. The intervention was EI coaching. The assessment used the Emotional and Social Competence Inventory, a 360-degree EI survey consisting of self and other (colleague) ratings for 12 EI competencies. There were 21 participants in each of the 3 assessments (test, posttest, and control). Our EI coaching intervention had very limited participation due to a lack of protected time for EI coaching and residents' competing obligations. Return rates for self surveys were 86% to 91% and 66% to 68% for others. On all 3 trials, ratings by others were significantly higher than self ratings for every competence (range, P < .001-.045). None of the self ratings by the intervention group increased significantly for any of the competencies. None of the intervention group self ratings increased significantly on posttesting, whereas ratings by others increased significantly for coach/mentor (P < .001). The teamwork rating decreased significantly on both self and other ratings (P < .001). Achievement orientation was the highest intervention group posttest rating, and teamwork was the lowest. EI is a necessary skill in today's health care environment, and our study found that a tool from another sector was useful in assessing resident EI skills. Because our EI coaching intervention was unsuccessful, the effects of coaching on interpersonal and communication skills could not be assessed.

  4. Graduate medical education competencies for international health electives: A qualitative study.

    PubMed

    Nordhues, Hannah C; Bashir, M Usmaan; Merry, Stephen P; Sawatsky, Adam P

    2017-11-01

    Residency programs offer international health electives (IHEs), providing multiple educational benefits. This study aimed to identify how IHEs fulfill the Accreditation Council for Graduate Medical Education (ACGME) core competencies. We conducted a thematic analysis of post-rotation reflective reports from residents who participated in IHEs through the Mayo International Health Program. We coded reports using a codebook created from the ACGME competencies. Using a constant comparative method, we identified significant themes within each competency. Residents from 40 specialties participated in 377 IHEs in 56 countries from 2001 to 2014. Multiple themes were identified within each of the six ACGME core competencies: Patient Care and Procedural Skills (4), Medical Knowledge (5), Practice-Based Learning and Improvement (3), Interpersonal and Communication Skills (5), Professionalism (4), and Systems-Based Practice and Improvement (3). Themes included improving physical exam and procedural skills, providing care in resource-limited setting, gaining knowledge of tropical and non-tropical diseases, identifying socioeconomic determinants of health, engaging in the education of others, and increasing communication across cultures and multidisciplinary teams. Through IHEs, residents advanced their knowledge, skills, and attitudes in each of the six ACGME competencies. These data can be used for development of IHE competencies and milestones for resident assessment.

  5. Shortening the Miles to the Milestones: Connecting EPA-Based Evaluations to ACGME Milestone Reports for Internal Medicine Residency Programs.

    PubMed

    Choe, John H; Knight, Christopher L; Stiling, Rebekah; Corning, Kelli; Lock, Keli; Steinberg, Kenneth P

    2016-07-01

    The Next Accreditation System requires internal medicine training programs to provide the Accreditation Council for Graduate Medical Education (ACGME) with semiannual information about each resident's progress in 22 subcompetency domains. Evaluation of resident "trustworthiness" in performing entrustable professional activities (EPAs) may offer a more tangible assessment construct than evaluations based on expectations of usual progression toward competence. However, translating results from EPA-based evaluations into ACGME milestone progress reports has proven to be challenging because the constructs that underlay these two systems differ.The authors describe a process to bridge the gap between rotation-specific EPA-based evaluations and ACGME milestone reporting. Developed at the University of Washington in 2012 and 2013, this method involves mapping EPA-based evaluation responses to "milestone elements," the narrative descriptions within the columns of each of the 22 internal medicine subcompetencies. As faculty members complete EPA-based evaluations, the mapped milestone elements are automatically marked as "confirmed." Programs can maintain a database that tallies the number of times each milestone element is confirmed for a resident; these data can be used to produce graphical displays of resident progress along the internal medicine milestones.Using this count of milestone elements allows programs to bridge the gap between faculty assessments of residents based on rotation-specific observed activities and semiannual ACGME reports based on the internal medicine milestones. Although potentially useful for all programs, this method is especially beneficial to large programs where clinical competency committee members may not have the opportunity for direct observation of all residents.

  6. Accreditation Council for Graduate Medical Education Core Competencies at a Community Teaching Hospital: Is There a Gap in Awareness?

    PubMed

    Al-Temimi, Mohammed; Kidon, Michael; Johna, Samir

    2016-01-01

    Reports evaluating faculty knowledge of the Accreditation Council for Graduate Medical Education (ACGME) core competencies in community hospitals without a dedicated residency program are uncommon. Faculty evaluation regarding knowledge of ACGME core competencies before a residency program is started. Physicians at the Kaiser Permanente Fontana Medical Center (N = 480) were surveyed for their knowledge of ACGME core competencies before starting new residency programs. Knowledge of ACGME core competencies. Fifty percent of physicians responded to the survey, and 172 (71%) of respondents were involved in teaching residents. Of physicians who taught residents and had complete responses (N = 164), 65 (39.7%) were unsure of their knowledge of the core competencies. However, most stated that they provided direct teaching to residents related to the knowledge, skills, and attitudes stated in each of the 6 competencies as follows: medical knowledge (96.3%), patient care (95.7%), professionalism (90.7%), interpersonal and communication skills (86.3%), practice-based learning (85.9%), and system-based practice (79.6%). Physician specialty, years in practice (1-10 vs > 10), and number of rotations taught per year (1-6 vs 7-12) were not associated with knowledge of the competencies (p > 0.05); however, full-time faculty (teaching 10-12 rotations per year) were more likely to provide competency-based teaching. Objective assessment of faculty awareness of ACGME core competencies is essential when starting a residency program. Discrepancy between knowledge of the competencies and acclaimed provision of competency-based teaching emphasizes the need for standardized teaching methods that incorporate the values of these competencies.

  7. Accreditation Council for Graduate Medical Education Core Competencies at a Community Teaching Hospital: Is There a Gap in Awareness?

    PubMed Central

    Al-Temimi, Mohammed; Kidon, Michael; Johna, Samir

    2016-01-01

    Context Reports evaluating faculty knowledge of the Accreditation Council for Graduate Medical Education (ACGME) core competencies in community hospitals without a dedicated residency program are uncommon. Objective Faculty evaluation regarding knowledge of ACGME core competencies before a residency program is started. Design Physicians at the Kaiser Permanente Fontana Medical Center (N = 480) were surveyed for their knowledge of ACGME core competencies before starting new residency programs. Main Outcome Measures Knowledge of ACGME core competencies. Results Fifty percent of physicians responded to the survey, and 172 (71%) of respondents were involved in teaching residents. Of physicians who taught residents and had complete responses (N = 164), 65 (39.7%) were unsure of their knowledge of the core competencies. However, most stated that they provided direct teaching to residents related to the knowledge, skills, and attitudes stated in each of the 6 competencies as follows: medical knowledge (96.3%), patient care (95.7%), professionalism (90.7%), interpersonal and communication skills (86.3%), practice-based learning (85.9%), and system-based practice (79.6%). Physician specialty, years in practice (1–10 vs > 10), and number of rotations taught per year (1–6 vs 7–12) were not associated with knowledge of the competencies (p > 0.05); however, full-time faculty (teaching 10–12 rotations per year) were more likely to provide competency-based teaching. Conclusion Objective assessment of faculty awareness of ACGME core competencies is essential when starting a residency program. Discrepancy between knowledge of the competencies and acclaimed provision of competency-based teaching emphasizes the need for standardized teaching methods that incorporate the values of these competencies. PMID:27768565

  8. Cultural Competency Training Requirements in Graduate Medical Education

    PubMed Central

    Ambrose, Adrian Jacques H.; Lin, Susan Y.; Chun, Maria B. J.

    2013-01-01

    Background Cultural competency is an important skill that prepares physicians to care for patients from diverse backgrounds. Objective We reviewed Accreditation Council for Graduate Medical Education (ACGME) program requirements and relevant documents from the ACGME website to evaluate competency requirements across specialties. Methods The program requirements for each specialty and its subspecialties were reviewed from December 2011 through February 2012. The review focused on the 3 competency domains relevant to culturally competent care: professionalism, interpersonal and communication skills, and patient care. Specialty and subspecialty requirements were assigned a score between 0 and 3 (from least specific to most specific). Given the lack of a standardized cultural competence rating system, the scoring was based on explicit mention of specific keywords. Results A majority of program requirements fell into the low- or no-specificity score (1 or 0). This included 21 core specialties (leading to primary board certification) program requirements (78%) and 101 subspecialty program requirements (79%). For all specialties, cultural competency elements did not gravitate toward any particular competency domain. Four of 5 primary care program requirements (pediatrics, obstetrics-gynecology, family medicine, and psychiatry) acquired the high-specificity score of 3, in comparison to only 1 of 22 specialty care program requirements (physical medicine and rehabilitation). Conclusions The degree of specificity, as judged by use of keywords in 3 competency domains, in ACGME requirements regarding cultural competency is highly variable across specialties and subspecialties. Greater specificity in requirements is expected to benefit the acquisition of cultural competency in residents, but this has not been empirically tested. PMID:24404264

  9. Meeting ACGME Standards Under a Unified Accreditation System: Challenges for Osteopathic Graduate Medical Education Programs.

    PubMed

    Cummings, Mark

    2017-07-01

    In 2014, the American Osteopathic Association (AOA) and the American Association of Colleges of Osteopathic Medicine signed a memorandum of understanding (MOU) with the Accreditation Council for Graduate Medical Education (ACGME) to create a unified accreditation system for graduate medical education (GME) under the ACGME. The AOA will cease to accredit GME programs on June 30, 2020. By then, AOA-accredited programs need to apply for and achieve ACGME initial accreditation. The terms of the MOU also made it advantageous for some formerly nonteaching hospitals to establish AOA programs, chiefly in primary care, as a step toward future ACGME accreditation.In transitioning AOA programs to the ACGME system, hospitals with osteopathic GME can expect to encounter challenges related to major differences between AOA and ACGME standards. The minimum numbers of residents for ACGME programs in most specialties are greater than those for AOA programs, which will require hospitals that may already be at their federal caps to add additional residency positions. ACGME standards are also more faculty- and staff-intensive and require additional infrastructure, necessitating additional financial investments. In addition, greater curricular specificity in ACGME standards will generate new educational and financial challenges.To address these challenges, hospitals may need to reallocate resources and positions among their current AOA programs, reducing the number of programs (and specialties) they sponsor. It is expected that a number of established and new AOA programs will choose not to pursue ACGME accreditation or will fail to qualify for ACGME initial accreditation.

  10. New ACGME Work-Hour Guidelines and Their Impact on Current Residency Training Practices

    ERIC Educational Resources Information Center

    Sattar, S. Pirzada; Basith, Fatima; Madison, James; Bhatia, Subhash C.

    2005-01-01

    Objective: Accreditation Council for Graduate Medical Education (ACGME) has introduced new work-hour guidelines for residents in ACGME accredited programs that were implemented in July 2003. The new ACGME policies impact several practices in various psychiatry residency programs across the U.S., even though psychiatry has not been at the forefront…

  11. Internal medicine rounding practices and the Accreditation Council for Graduate Medical Education core competencies.

    PubMed

    Shoeb, Marwa; Khanna, Raman; Fang, Margaret; Sharpe, Brad; Finn, Kathleen; Ranji, Sumant; Monash, Brad

    2014-04-01

    The Accreditation Council for Graduate Medical Education (ACGME) has established the requirement for residency programs to assess trainees' competencies in 6 core domains (patient care, medical knowledge, practice-based learning, interpersonal skills, professionalism, and systems-based practice). As attending rounds serve as a primary means for educating trainees at academic medical centers, our study aimed to identify current rounding practices and attending physician perceived capacity of different rounding models to promote teaching within the ACGME core competencies. We disseminated a 24-question survey electronically using educational and hospital medicine leadership mailing lists. We assessed attending physician demographics and the frequency with which they used various rounding models, as defined by the location of the discussion of the patient and care plan: bedside rounds (BR), hallway rounds (HR), and card-flipping rounds (CFR). Using the ACGME framework, we assessed the perceived educational value of each model. We received 153 completed surveys from attending physicians representing 34 institutions. HR was used most frequently for both new and established patients (61% and 43%), followed by CFR for established patients (36%) and BR for new patients (22%). Most attending physicians indicated that BR and HR were superior to CFR in promoting the following ACGME competencies: patient care, systems-based practice, professionalism, and interpersonal skills. HR is the most commonly employed rounding model. BR and HR are perceived to be valuable for teaching patient care, systems-based practice, professionalism, and interpersonal skills. CFR remains prevalent despite its perceived inferiority in promoting teaching across most of the ACGME core competencies. © 2014 Society of Hospital Medicine.

  12. Building a Competency-Based Curriculum: The Agony and the Ecstasy

    ERIC Educational Resources Information Center

    Albanese, Mark A.; Mejicano, George; Anderson, W. Marshall; Gruppen, Larry

    2010-01-01

    Physician competencies have increasingly been a focus of medical education at all levels. Although competencies are not a new concept, when the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS) jointly agreed on six competencies for certification and maintenance of certification of…

  13. Culture Competence in the Training of Geriatric Medicine Fellows

    ERIC Educational Resources Information Center

    Tanabe, Marianne K. G.

    2007-01-01

    With the aging and diversifying of the elder population in the United States, there is a pressing need for an organized and effective curriculum in cultural competence. The Accreditation Council for Graduate Medical Education (ACGME) requires that the curriculum for Geriatric Medicine Fellowship training include cultural competency training.…

  14. Tools to Assess Behavioral and Social Science Competencies in Medical Education: A Systematic Review.

    PubMed

    Carney, Patricia A; Palmer, Ryan T; Fuqua Miller, Marissa; Thayer, Erin K; Estroff, Sue E; Litzelman, Debra K; Biagioli, Frances E; Teal, Cayla R; Lambros, Ann; Hatt, William J; Satterfield, Jason M

    2016-05-01

    Behavioral and social science (BSS) competencies are needed to provide quality health care, but psychometrically validated measures to assess these competencies are difficult to find. Moreover, they have not been mapped to existing frameworks, like those from the Liaison Committee on Medical Education (LCME) and Accreditation Council for Graduate Medical Education (ACGME). This systematic review aimed to identify and evaluate the quality of assessment tools used to measure BSS competencies. The authors searched the literature published between January 2002 and March 2014 for articles reporting psychometric or other validity/reliability testing, using OVID, CINAHL, PubMed, ERIC, Research and Development Resource Base, SOCIOFILE, and PsycINFO. They reviewed 5,104 potentially relevant titles and abstracts. To guide their review, they mapped BSS competencies to existing LCME and ACGME frameworks. The final included articles fell into three categories: instrument development, which were of the highest quality; educational research, which were of the second highest quality; and curriculum evaluation, which were of lower quality. Of the 114 included articles, 33 (29%) yielded strong evidence supporting tools to assess communication skills, cultural competence, empathy/compassion, behavioral health counseling, professionalism, and teamwork. Sixty-two (54%) articles yielded moderate evidence and 19 (17%) weak evidence. Articles mapped to all LCME standards and ACGME core competencies; the most common was communication skills. These findings serve as a valuable resource for medical educators and researchers. More rigorous measurement validation and testing and more robust study designs are needed to understand how educational strategies contribute to BSS competency development.

  15. Tools to Assess Behavioral and Social Science Competencies in Medical Education: A Systematic Review

    PubMed Central

    Carney, Patricia A.; Palmer, Ryan T.; Miller, Marissa Fuqua; Thayer, Erin K.; Estroff, Sue E.; Litzelman, Debra K.; Biagioli, Frances E.; Teal, Cayla R.; Lambros, Ann; Hatt, William J.; Satterfield, Jason M.

    2015-01-01

    Purpose Behavioral and social science (BSS) competencies are needed to provide quality health care, but psychometrically validated measures to assess these competencies are difficult to find. Moreover, they have not been mapped to existing frameworks, like those from the Liaison Committee on Medical Education (LCME) and Accreditation Council for Graduate Medical Education (ACGME). This systematic review aimed to identify and evaluate the quality of assessment tools used to measure BSS competencies. Method The authors searched the literature published between January 2002 and March 2014 for articles reporting psychometric or other validity/reliability testing, using OVID, CINAHL, PubMed, ERIC, Research and Development Resource Base, SOCIOFILE, and PsycINFO. They reviewed 5,104 potentially relevant titles and abstracts. To guide their review, they mapped BSS competencies to existing LCME and ACGME frameworks. The final, included articles fell into three categories: instrument development, which were of the highest quality; educational research, which were of the second highest quality; and curriculum evaluation, which were of lower quality. Results Of the 114 included articles, 33 (29%) yielded strong evidence supporting tools to assess communication skills, cultural competence, empathy/compassion, behavioral health counseling, professionalism, and teamwork. Sixty-two (54%) articles yielded moderate evidence and 19 (17%) weak evidence. Articles mapped to all LCME standards and ACGME core competencies; the most common was communication skills. Conclusions These findings serve as a valuable resource for medical educators and researchers. More rigorous measurement validation and testing and more robust study designs are needed to understand how educational strategies contribute to BSS competency development. PMID:26796091

  16. Ways to Write a Milestone: Approaches to Operationalizing the Development of Competence in Graduate Medical Education.

    PubMed

    Leep Hunderfund, Andrea N; Reed, Darcy A; Starr, Stephanie R; Havyer, Rachel D; Lang, Tara R; Norby, Suzanne M

    2017-09-01

    To identify approaches to operationalizing the development of competence in Accreditation Council for Graduate Medical Education (ACGME) milestones. The authors reviewed all 25 "Milestone Project" documents available on the ACGME Web site on September 11, 2013, using an iterative process to identify approaches to operationalizing the development of competence in the milestones associated with each of 601 subcompetencies. Fifteen approaches were identified. Ten focused on attributes and activities of the learner, such as their ability to perform different, increasingly difficult tasks (304/601; 51%), perform a task better and faster (171/601; 45%), or perform a task more consistently (123/601; 20%). Two approaches focused on context, inferring competence from performing a task in increasingly difficult situations (236/601; 29%) or an expanding scope of engagement (169/601; 28%). Two used socially defined indicators of competence such as progression from "learning" to "teaching," "leading," or "role modeling" (271/601; 45%). One approach focused on the supervisor's role, inferring competence from a decreasing need for supervision or assistance (151/601; 25%). Multiple approaches were often combined within a single set of milestones (mean 3.9, SD 1.6). Initial ACGME milestones operationalize the development of competence in many ways. These findings offer insights into how physicians understand and assess the developmental progression of competence and an opportunity to consider how different approaches may affect the validity of milestone-based assessments. The results of this analysis can inform the work of educators developing or revising milestones, interpreting milestone data, or creating assessment tools to inform milestone-based performance measures.

  17. Recommended integrative medicine competencies for family medicine residents.

    PubMed

    Locke, Amy B; Gordon, Andrea; Guerrera, Mary P; Gardiner, Paula; Lebensohn, Patricia

    2013-01-01

    The use of complementary and alternative medicine (CAM) and Integrative Medicine (IM) has grown steadily over the past decade. Patients seek physician guidance, yet physicians typically have limited knowledge and training. There is some coverage of IM/CAM topics in medical schools and residencies but with little coordination or consistency. In 2008, the Society of Teachers of Family Medicine (STFM) group on Integrative Medicine began the process of designing a set of competencies to educate Family Medicine residents in core concepts of IM. The goal was creation of a set of nationally recognized competencies tied to the Accreditation Council for Graduate Medical Education (ACGME) domains. These competencies were to be achievable by diverse programs, including those without significant internal resources. The group compiled existing curricula from programs around the country and distilled these competencies through multiple reviews and discussions. Simultaneously, the Integrative Medicine in Residency program run by the University of Arizona underwent a similar process. In 2009, these competencies were combined and further developed at the STFM annual meeting by a group of experts. In 2010, the STFM Board approved 19 measurable competencies, each categorized by ACGME domain, as recommended for Family Medicine residencies. Programs have implemented these competencies in various ways given individual needs and resources. This paper reviews the development of IM competencies for residency education in Family Medicine and presents those endorsed by STFM. By educating physicians in training about IM/CAM via competency-based curricula, we aim to promote comprehensive patient-centered care. © 2013 Elsevier Inc. All rights reserved.

  18. The Core Competencies for General Orthopaedic Surgeons.

    PubMed

    Kellam, James F; Archibald, Douglas; Barber, James W; Christian, Eugene P; D'Ascoli, Richard J; Haynes, Richard J; Hecht, Suzanne S; Hurwitz, Shepard R; Kellam, James F; McLaren, Alexander C; Peabody, Terrance D; Southworth, Stephen R; Strauss, Robert W; Wadey, Veronica M R

    2017-01-18

    With the changing delivery of orthopaedic surgical care, there is a need to define the knowledge and competencies that are expected of an orthopaedist providing general and/or acute orthopaedic care. This article provides a proposal for the knowledge and competencies needed for an orthopaedist to practice general and/or acute care orthopaedic surgery. Using the modified Delphi method, the General Orthopaedic Competency Task Force consisting of stakeholders associated with general orthopaedic practice has proposed the core knowledge and competencies that should be maintained by orthopaedists who practice emergency and general orthopaedic surgery. For relevancy to clinical practice, 2 basic sets of competencies were established. The assessment competencies pertain to the general knowledge needed to evaluate, investigate, and determine an overall management plan. The management competencies are generally procedural in nature and are divided into 2 groups. For the Management 1 group, the orthopaedist should be competent to provide definitive care including assessment, investigation, initial or emergency care, operative or nonoperative care, and follow-up. For the Management 2 group, the orthopaedist should be competent to assess, investigate, and commence timely non-emergency or emergency care and then either transfer the patient to the appropriate subspecialist's care or provide definitive care based on the urgency of care, exceptional practice circumstance, or individual's higher training. This may include some higher-level procedures usually performed by a subspecialist, but are consistent with one's practice based on experience, practice environment, and/or specialty interest. These competencies are the first step in defining the practice of general orthopaedic surgery including acute orthopaedic care. Further validation and discussion among educators, general orthopaedic surgeons, and subspecialists will ensure that these are relevant to clinical practice. These

  19. Definitions and competencies for practice-based learning and improvement.

    PubMed

    Hayden, Stephen R; Dufel, Susan; Shih, Richard

    2002-11-01

    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.

  20. The impact of osteopathic physicians' participation in ACGME-accredited postdoctoral programs, 1985-2006.

    PubMed

    Cummings, Mark; Sefcik, Donald J

    2009-06-01

    Between 1985 and 2006, the number of osteopathic physicians (DOs) training in Accreditation Council for Graduate Medical Education (ACGME) postdoctoral (i.e., residency and fellowship) programs increased by 5,352 (419%). In 2006, more than two of every three DOs (6,629 of 9,618) in postdoctoral training were in an ACGME program. The integration of osteopathic physicians into these programs was facilitated by several factors. The most important of these was a noted growth in the number and types of ACGME programs and a consistent number of U.S. MD graduates (USMDs) from schools accredited by the Liaison Committee on Medical Education (LCME). From 1985 to 2006, the number of all physicians in ACGME programs, both DO and MD, grew by 30,365 (41%). DOs were most often selected for specialties less populated by USMDs, chiefly family and internal medicine and pediatrics.Growth patterns in LCME medical schools project an increase in the national class size to accommodate 3,400 more students by 2012, a 21% increase. The development of new colleges of osteopathic medicine (COMs) and expansion in existing ones is expected to generate 5,227 first-year students in 2012, an increase of 1,380 students (36%) over 2006 numbers. The overwhelming majority of these anticipated new COM graduates cannot be accommodated in American Osteopathic Association postdoctoral programs because of limited capacity. As these additional LCME graduates move into their postdoctoral training, educational opportunities for DOs are expected to decline and competition is expected to become stiffer. The window of opportunity for DOs in ACGME programs that opened in the last two decades will gradually start to close.

  1. Use of a Clinical Pathologic Conference to Demonstrate Residents' ACGME Emergency Medicine Milestones, Aid in Faculty Development, and Increase Academic Output.

    PubMed

    Kane, Kathleen; Weaver, Kevin; Barr, Gavin; Quinn, Shawn; Goyke, Terrence; Smith, Amy; Yenser, Dawn; Kane, Bryan

    2018-06-01

    The Emergency Medicine Milestones Project, developed by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Emergency Medicine, includes competence targets for residents to attain and, ultimately, to exceed American Osteopathic Association and ACGME expectations for residents. The authors sought to use the clinical pathologic conference (CPC) format in their institutions' Emergency Medicine Milestones Project to provide measurable residency academic and faculty development outcomes. The CPC is an event in which a resident presents an unknown case to a discussant in advance of a didactic session to demonstrate an organized approach and decision-making rationale to a differential diagnosis. Feedback forms included the assessment of resident discussants from the perspective of level-5 Milestone achievements in particular. Developing an internal CPC competition with a dedicated core faculty coordinator who provides skill development for both resident and faculty presentation has proven successful. Such a competition can document the level-5 achievements for senior residents, be a source of faculty development, and increase peer-reviewed academic output.

  2. Community College General Academic Course Guide Manual.

    ERIC Educational Resources Information Center

    Texas Higher Education Coordinating Board, Austin. Div. of Community and Technical Colleges.

    The Community College General Academic Course Guide Manual (ACGM) is the official list of approved numbers for general academic transfer courses that may be offered by public community and technical colleges in Texas for state funding. This edition of the ACGM, effective September 1996, contains the latest information available for academic…

  3. Relationships between high-stakes clinical skills exam scores and program director global competency ratings of first-year pediatric residents

    PubMed Central

    Langenau, Erik E.; Pugliano, Gina; Roberts, William L.

    2011-01-01

    Background Responding to mandates from the Accreditation Council for Graduate Medical Education (ACGME) and American Osteopathic Association (AOA), residency programs have developed competency-based assessment tools. One such tool is the American College of Osteopathic Pediatricians (ACOP) program directors’ annual report. High-stakes clinical skills licensing examinations, such as the Comprehensive Osteopathic Medical Licensing Examination Level 2-Performance Evaluation (COMLEX-USA Level 2-PE), also assess competency in several clinical domains. Objective The purpose of this study is to investigate the relationships between program director competency ratings of first-year osteopathic residents in pediatrics and COMLEX-USA Level 2-PE scores from 2005 to 2009. Methods The sample included all 94 pediatric first-year residents who took COMLEX-USA Level 2-PE and whose training was reviewed by the ACOP for approval of training between 2005 and 2009. Program director competency ratings and COMLEX-USA Level 2-PE scores (domain and component) were merged and analyzed for relationships. Results Biomedical/biomechanical domain scores were positively correlated with overall program director competency ratings. Humanistic domain scores were not significantly correlated with overall program director competency ratings, but did show moderate correlation with ratings for interpersonal and communication skills. The six ACGME or seven AOA competencies assessed empirically by the ACOP program directors’ annual report could not be recovered by principal component analysis; instead, three factors were identified, accounting for 86% of the variance between competency ratings. Discussion A few significant correlations were noted between COMLEX-USA Level 2-PE scores and program director competency ratings. Exploring relationships between different clinical skills assessments is inherently difficult because of the heterogeneity of tools used and overlap of constructs within the AOA

  4. Student Experiences with Competency Domains during a Psychiatry Clerkship

    ERIC Educational Resources Information Center

    West, Donald A.; Nierenberg, David W.

    2009-01-01

    Objectives: The authors reviewed medical student encounters during 3 years of a required psychiatry clerkship that were recorded on a web-based system of six broad competency domains (similar to ACGME-recommended domains). These were used to determine diagnoses of patients seen, clinical skills practiced, and experiences in interpersonal and…

  5. Nurse-Led Competency Model for Emergency Physicians: A Qualitative Study.

    PubMed

    Daouk-Öyry, Lina; Mufarrij, Afif; Khalil, Maya; Sahakian, Tina; Saliba, Miriam; Jabbour, Rima; Hitti, Eveline

    2017-09-01

    To develop a competency model for emergency physicians from the perspective of nurses, juxtapose this model with the widely adopted Accreditation Council for Graduate Medical Education (ACGME) model, and identify competencies that might be unique to the nurses' perspective. The study relied on secondary data originally collected as part of nurses' assessment of emergency physicians' nonclinical skills in the emergency department (ED) of an academic medical center in the Middle East. Participants were 36 registered nurses who had worked in the ED for at least 2 years and had worked for at least 2 shifts per month with the physician being evaluated. Through content analysis, a nurse-led competency model was identified, including 8 core competencies encompassing 33 subcompetencies. The 8 core competencies were emotional intelligence; problem-solving and decisionmaking skills; operations management; patient focus; patient care, procedural skills, and medical knowledge; professionalism; communication skills; and team leadership and management. When the developed model was compared with the ACGME model, the 2 models diverged more than they converged. The nurses' perspective offered distinctive insight into the competencies needed for physicians in an emergency medicine environment, indicating the value of nurses' perspective and shedding light on the need for more systematic and more methodologically sound studies to examine the issue further. The differences between the models highlighted the competencies that were unique to the nurse perspective, and the similarities were indicative of the influence of different perspectives and organizational context on how competencies manifest. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  6. Psychiatry Resident Training in Cultural Competence: An Educator's Toolkit.

    PubMed

    Corral, Irma; Johnson, Toni L; Shelton, Pheston G; Glass, Oliver

    2017-06-01

    Resident physicians training in psychiatry in the U.S. are required to master a body of knowledge related to cultural psychiatry; are expected to adopt attitudes that endorse the principles of cultural competence; and finally are expected to acquire specific cultural competence skills that facilitate working effectively with diverse patients. This article first provides an overview of the Accreditation Council for Graduate Medical Education (ACGME) competencies related to cultural competence, as well as the American Academy of Child and Adolescent Psychiatry's (AACAP) recommendations for the cultural competence training of child/adolescent fellows. Next, numerous print and electronic resources that can be used in cultural competence education in psychiatry are reviewed and discussed. Finally, we conclude by providing recommendations for psychiatry residency programs that we culled from model cultural competence curricula.

  7. Psychotherapy Training for Residents: Reconciling Requirements with Evidence-Based, Competency-Focused Practice

    ERIC Educational Resources Information Center

    Weerasekera, Priyanthy; Manring, John; Lynn, David John

    2010-01-01

    Objective: The Accreditation Council for Graduate Medical Education (ACGME) and the Royal College of Physicians and Surgeons of Canada (RCPSC) changed the training requirements in psychotherapy, moving toward evidence-based therapies and emphasizing competence and proficiency as outcomes of training. This article examines whether the therapies…

  8. 29 CFR 18.601 - General rule of competency.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true General rule of competency. 18.601 Section 18.601 Labor... OFFICE OF ADMINISTRATIVE LAW JUDGES Rules of Evidence Witnesses § 18.601 General rule of competency... competency of a witness shall be determined in accordance with State law. ...

  9. Mapping cognitive overlaps between practice-based learning and improvement and evidence-based medicine: an operational definition for assessing resident physician competence.

    PubMed

    Chatterji, Madhabi; Graham, Mark J; Wyer, Peter C

    2009-12-01

    The complex competency labeled practice-based learning and improvement (PBLI) by the Accreditation Council for Graduate Medical Education (ACGME) incorporates core knowledge in evidence-based medicine (EBM). The purpose of this study was to operationally define a "PBLI-EBM" domain for assessing resident physician competence. The authors used an iterative design process to first content analyze and map correspondences between ACGME and EBM literature sources. The project team, including content and measurement experts and residents/fellows, parsed, classified, and hierarchically organized embedded learning outcomes using a literature-supported cognitive taxonomy. A pool of 141 items was produced from the domain and assessment specifications. The PBLI-EBM domain and resulting items were content validated through formal reviews by a national panel of experts. The final domain represents overlapping PBLI and EBM cognitive dimensions measurable through written, multiple-choice assessments. It is organized as 4 subdomains of clinical action: Therapy, Prognosis, Diagnosis, and Harm. Four broad cognitive skill branches (Ask, Acquire, Appraise, and Apply) are subsumed under each subdomain. Each skill branch is defined by enabling skills that specify the cognitive processes, content, and conditions pertinent to demonstrable competence. Most items passed content validity screening criteria and were prepared for test form assembly and administration. The operational definition of PBLI-EBM competence is based on a rigorously developed and validated domain and item pool, and substantially expands conventional understandings of EBM. The domain, assessment specifications, and procedures outlined may be used to design written assessments to tap important cognitive dimensions of the overall PBLI competency, as given by ACGME. For more comprehensive coverage of the PBLI competency, such instruments need to be complemented with performance assessments.

  10. Core Competencies in Integrative Pain Care for Entry-Level Primary Care Physicians.

    PubMed

    Tick, Heather; Chauvin, Sheila W; Brown, Michael; Haramati, Aviad

    2015-11-01

    The objective was to develop a set of core competencies for graduating primary care physicians in integrative pain care (IPC), using the Accreditation Council for Graduate Medical Education (ACGME) domains. These competencies build on previous work in competencies for integrative medicine, interprofessional education, and pain medicine and are proposed for inclusion in residency training. A task force was formed to include representation from various professionals who are involved in education, research, and the practice of IPC and who represent broad areas of expertise. The task force convened during a 1.5-day face-to-face meeting, followed by a series of surveys and other vetting processes involving diverse interprofessional groups, which led to the consensus of a final set of competencies. The proposed competencies focus on interprofessional knowledge, skills, and attitudes (KSAs) and are in line with recommendations by the Institute of Medicine, military medicine, and professional pain societies advocating the need for coordination and integration of services for effective pain care with reduced risk and cost and improved outcomes. These ACGME domain compatible competencies for physicians reflect the contributions of several disciplines that will need to be included in evolving interprofessional settings and underscore the need for collaborative care. These core competencies can guide the incorporation of KSAs within curricula. The learning experiences should enable medical educators and graduating primary care physicians to focus more on integrative approaches, interprofessional team-based, patient-centered care that use evidence-based, traditional and complementary disciplines and therapeutics to provide safe and effective treatments for people in pain. Wiley Periodicals, Inc.

  11. A core competency-based objective structured clinical examination (OSCE) can predict future resident performance.

    PubMed

    Wallenstein, Joshua; Heron, Sheryl; Santen, Sally; Shayne, Philip; Ander, Douglas

    2010-10-01

    This study evaluated the ability of an objective structured clinical examination (OSCE) administered in the first month of residency to predict future resident performance in the Accreditation Council for Graduate Medical Education (ACGME) core competencies. Eighteen Postgraduate Year 1 (PGY-1) residents completed a five-station OSCE in the first month of postgraduate training. Performance was graded in each of the ACGME core competencies. At the end of 18 months of training, faculty evaluations of resident performance in the emergency department (ED) were used to calculate a cumulative clinical evaluation score for each core competency. The correlations between OSCE scores and clinical evaluation scores at 18 months were assessed on an overall level and in each core competency. There was a statistically significant correlation between overall OSCE scores and overall clinical evaluation scores (R = 0.48, p < 0.05) and in the individual competencies of patient care (R = 0.49, p < 0.05), medical knowledge (R = 0.59, p < 0.05), and practice-based learning (R = 0.49, p < 0.05). No correlation was noted in the systems-based practice, interpersonal and communication skills, or professionalism competencies. An early-residency OSCE has the ability to predict future postgraduate performance on a global level and in specific core competencies. Used appropriately, such information can be a valuable tool for program directors in monitoring residents' progress and providing more tailored guidance. © 2010 by the Society for Academic Emergency Medicine.

  12. Peer chart audits: a tool to meet Accreditation Council on Graduate Medical Education (ACGME) competency in practice-based learning and improvement.

    PubMed

    Staton, Lisa J; Kraemer, Suzanne M; Patel, Sangnya; Talente, Gregg M; Estrada, Carlos A

    2007-07-27

    The Accreditation Council on Graduate Medical Education (ACGME) supports chart audit as a method to track competency in Practice-Based Learning and Improvement. We examined whether peer chart audits performed by internal medicine residents were associated with improved documentation of foot care in patients with diabetes mellitus. A retrospective electronic chart review was performed on 347 patients with diabetes mellitus cared for by internal medicine residents in a university-based continuity clinic from May 2003 to September 2004. Residents abstracted information pertaining to documentation of foot examinations (neurological, vascular, and skin) from the charts of patients followed by their physician peers. No formal feedback or education was provided. Significant improvement in the documentation of foot exams was observed over the course of the study. The percentage of patients receiving neurological, vascular, and skin exams increased by 20% (from 13% to 33%) (p = 0.001), 26% (from 45% to 71%) (p < 0.001), and 18% (51%-72%) (p = 0.005), respectively. Similarly, the proportion of patients receiving a well-documented exam which includes all three components - neurological, vascular and skin foot exam - increased over time (6% to 24%, p < 0.001). Peer chart audits performed by residents in the absence of formal feedback were associated with improved documentation of the foot exam in patients with diabetes mellitus. Although this study suggests that peer chart audits may be an effective tool to improve practice-based learning and documentation of foot care in diabetic patients, evaluating the actual performance of clinical care was beyond the scope of this study and would be better addressed by a randomized controlled trial.

  13. Mapping Residency Global Health Experiences to the ACGME Family Medicine Milestones.

    PubMed

    Grissom, Maureen O; Iroku-Malize, Tochi; Peila, Rita; Perez, Marco; Philippe, Neubert

    2017-07-01

    Global health (GH) experiences are a unique part of family medicine (FM) training that offer an opportunity for residents to demonstrate development across a multitude of the milestones recently implemented by the Accreditation Council for Graduate Medical Education (ACGME). The GH experience presents an opportunity for resident development, and including a component of written reflection can provide tangible evidence of development in areas that can be difficult to assess. A mixed methods approach was used to integrate quantitative (frequency) data with qualitative content from the written reflections of 12 of our FM residents who participated in GH experiences. Written reflections touched on each of the 22 milestones, although some milestones were noted more frequently than others. The most commonly identified milestones fell within the competency areas of systems-based practice, professionalism, and practice-based learning and improvement. Our qualitative approach allowed us to gain an appreciation of the unique experiences that demonstrated growth across the various milestones. We conclude that any program that offers GH experiences should incorporate some form of written reflection to maximize resident growth and offer evaluative faculty a window into that development.

  14. General Marketing. Occupational Competency Analysis Profile.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Vocational Instructional Materials Lab.

    This General Marketing Occupational Competency Analysis Profile (OCAP) is one of a series of competency lists, verified by expert workers, that have evolved from a modified DACUM (Developing a Curriculum) job analysis process involving business, industry, labor, and community agency representatives from throughout Ohio. This OCAP identifies the…

  15. A case study of translating ACGME practice-based learning and improvement requirements into reality: systems quality improvement projects as the key component to a comprehensive curriculum.

    PubMed

    Tomolo, A M; Lawrence, R H; Aron, D C

    2009-10-01

    In 2002, the Accreditation Council for Graduate Medical Education (ACGME) introduced a new requirement: residents must demonstrate competency in Practice-Based Learning and Improvement (PBLI). Training in this domain is still not consistently integrated into programmes, with few, if any, adequately going beyond knowledge of basic content and addressing all components of the requirement. To summarise the implementation of a PBLI curriculum designed to address all components of the requirement and to evaluate the impact on the practice system. A case-study approach was used for identifying and evaluating the steps for delivering the curriculum, along with the Model for Improvement's successive Plan-Do-Study-Act (PDSA) cycles (July 2004-May 2006). Notes from curriculum development meetings, notes and presentation slides made by teams about their projects, resident curriculum exit evaluations curriculum and interviews. Residents reported high levels of comfort by applying PBLI-related knowledge and skills and that the curriculum improved their ability to do various PBLI tasks. The involvement of multiple stakeholders increased. Twelve of the 15 teams' suggestions with practical systems-relevant outcomes were implemented and sustained beyond residents' project periods. While using the traditional PDSA cycles was helpful, there were limitations. A PBLI curriculum that is centred around practice-based quality improvement projects can fulfil the objectives of this ACGME competency while accomplishing sustained outcomes in quality improvement. A comprehensive curriculum is an investment but offers organisational rewards. We propose a more realistic and informative representation of rapid PDSA cycle changes.

  16. A case study of translating ACGME practice-based learning and improvement requirements into reality: systems quality improvement projects as the key component to a comprehensive curriculum.

    PubMed

    Tomolo, A M; Lawrence, R H; Aron, D C

    2009-06-01

    In 2002, the Accreditation Council for Graduate Medical Education (ACGME) introduced a new requirement: residents must demonstrate competency in Practice-Based Learning and Improvement (PBLI). Training in this domain is still not consistently integrated into programmes, with few, if any, adequately going beyond knowledge of basic content and addressing all components of the requirement. To summarise the implementation of a PBLI curriculum designed to address all components of the requirement and to evaluate the impact on the practice system. A case-study approach was used for identifying and evaluating the steps for delivering the curriculum, along with the Model for Improvement's successive Plan-Do-Study-Act (PDSA) cycles (July 2004-May 2006). Notes from curriculum development meetings, notes and presentation slides made by teams about their projects, resident curriculum exit evaluations curriculum and interviews. Residents reported high levels of comfort by applying PBLI-related knowledge and skills and that the curriculum improved their ability to do various PBLI tasks. The involvement of multiple stakeholders increased. Twelve of the 15 teams' suggestions with practical systems-relevant outcomes were implemented and sustained beyond residents' project periods. While using the traditional PDSA cycles was helpful, there were limitations. A PBLI curriculum that is centred around practice-based quality improvement projects can fulfil the objectives of this ACGME competency while accomplishing sustained outcomes in quality improvement. A comprehensive curriculum is an investment but offers organisational rewards. We propose a more realistic and informative representation of rapid PDSA cycle changes.

  17. Mapping Cognitive Overlaps Between Practice-Based Learning and Improvement and Evidence-Based Medicine: An Operational Definition for Assessing Resident Physician Competence

    PubMed Central

    Chatterji, Madhabi; Graham, Mark J.; Wyer, Peter C.

    2009-01-01

    Purpose The complex competency labeled practice-based learning and improvement (PBLI) by the Accreditation Council for Graduate Medical Education (ACGME) incorporates core knowledge in evidence-based medicine (EBM). The purpose of this study was to operationally define a “PBLI-EBM” domain for assessing resident physician competence. Method The authors used an iterative design process to first content analyze and map correspondences between ACGME and EBM literature sources. The project team, including content and measurement experts and residents/fellows, parsed, classified, and hierarchically organized embedded learning outcomes using a literature-supported cognitive taxonomy. A pool of 141 items was produced from the domain and assessment specifications. The PBLI-EBM domain and resulting items were content validated through formal reviews by a national panel of experts. Results The final domain represents overlapping PBLI and EBM cognitive dimensions measurable through written, multiple-choice assessments. It is organized as 4 subdomains of clinical action: Therapy, Prognosis, Diagnosis, and Harm. Four broad cognitive skill branches (Ask, Acquire, Appraise, and Apply) are subsumed under each subdomain. Each skill branch is defined by enabling skills that specify the cognitive processes, content, and conditions pertinent to demonstrable competence. Most items passed content validity screening criteria and were prepared for test form assembly and administration. Conclusions The operational definition of PBLI-EBM competence is based on a rigorously developed and validated domain and item pool, and substantially expands conventional understandings of EBM. The domain, assessment specifications, and procedures outlined may be used to design written assessments to tap important cognitive dimensions of the overall PBLI competency, as given by ACGME. For more comprehensive coverage of the PBLI competency, such instruments need to be complemented with performance

  18. 'Correction:'Peer chart audits: A tool to meet Accreditation Council on Graduate Medical Education (ACGME) competency in practice-based learning and improvement

    PubMed Central

    Staton, Lisa J; Kraemer, Suzanne M; Patel, Sangnya; Talente, Gregg M; Estrada, Carlos A

    2007-01-01

    Background The Accreditation Council on Graduate Medical Education (ACGME) supports chart audit as a method to track competency in Practice-Based Learning and Improvement. We examined whether peer chart audits performed by internal medicine residents were associated with improved documentation of foot care in patients with diabetes mellitus. Methods A retrospective electronic chart review was performed on 347 patients with diabetes mellitus cared for by internal medicine residents in a university-based continuity clinic from May 2003 to September 2004. Residents abstracted information pertaining to documentation of foot examinations (neurological, vascular, and skin) from the charts of patients followed by their physician peers. No formal feedback or education was provided. Results Significant improvement in the documentation of foot exams was observed over the course of the study. The percentage of patients receiving neurological, vascular, and skin exams increased by 20% (from 13% to 33%) (p = 0.001), 26% (from 45% to 71%) (p < 0.001), and 18% (51%–72%) (p = 0.005), respectively. Similarly, the proportion of patients receiving a well-documented exam which includes all three components – neurological, vascular and skin foot exam – increased over time (6% to 24%, p < 0.001). Conclusion Peer chart audits performed by residents in the absence of formal feedback were associated with improved documentation of the foot exam in patients with diabetes mellitus. Although this study suggests that peer chart audits may be an effective tool to improve practice-based learning and documentation of foot care in diabetic patients, evaluating the actual performance of clinical care was beyond the scope of this study and would be better addressed by a randomized controlled trial. PMID:17662124

  19. Variation in National ACGME Case Log Data for Pediatric Orthopaedic Fellowships: Are Fellow Coding Practices Responsible?

    PubMed

    McClure, Philip K; Woiczik, Marcella; Karol, Lori; Sankar, Wudbhav N

    The introduction of the 80-hour work week for Accreditation Council for Graduate Medical Education (ACGME) accredited fellowship programs initiated many efforts to optimize surgical training. One particular area of interest is on recording and tracking surgical experiences. The current standard is logging cases based on Current Procedural Terminology codes, which are primarily designed for billing. Proposed guidelines from the ACGME regarding logging exist, but their implementation is unknown, as is the variation in case volume across fellowship programs. The purpose of this study was to investigate variability in the national case log data, and explore potential sources of variation using fellow surveys. National ACGME case log data for pediatric orthopaedic fellowships from 2012 to 2015 were reviewed, with particular attention to the domains of spine, pelvis/hip, arthroscopy, trauma, and other (which includes clubfoot casting). To explore potential sources of case log variability, a survey on case logging behavior was distributed to all pediatric orthopaedic fellows for the academic year 2015 to 2016. Reported experiences based on ACGME case logs varied widely between fellows with percentage difference of up to 100% in all areas. Similarly, wide variability is present in coding practices of pediatric orthopaedic fellows, who often lack formal education on the topic of appropriate coding/logging. In the survey, hypothetical case scenarios had an absolute difference in recorded codes of up to 13 and a percentage difference of up to 100%. ACGME case log data for pediatric orthopaedic fellowships demonstrates wide variability in reported surgical experiences. This variability may be due, in part, to differences in logging practices by individual fellows. This observation makes meaningful interpretation of national data on surgical volume challenging. Proposed surgical experience minimums should be interpreted in light of these data, and may not be advisable unless

  20. Restructuring a basic science course for core competencies: an example from anatomy teaching.

    PubMed

    Gregory, Jeremy K; Lachman, Nirusha; Camp, Christopher L; Chen, Laura P; Pawlina, Wojciech

    2009-09-01

    Medical schools revise their curricula in order to develop physicians best skilled to serve the public's needs. To ensure a smooth transition to residency programs, undergraduate medical education is often driven by the six core competencies endorsed by the Accreditation Council for Graduate Medical Education (ACGME): patient care, medical knowledge, practice-based learning, interpersonal skills, professionalism, and systems-based practice. Recent curricular redesign at Mayo Medical School provided an opportunity to restructure anatomy education and integrate radiology with first-year gross and developmental anatomy. The resulting 6-week (120-contact-hour) human structure block provides students with opportunities to learn gross anatomy through dissection, radiologic imaging, and embryologic correlation. We report more than 20 educational interventions from the human structure block that may serve as a model for incorporating the ACGME core competencies into basic science and early medical education. The block emphasizes clinically-oriented anatomy, invites self- and peer-evaluation, provides daily formative feedback through an audience response system, and employs team-based learning. The course includes didactic briefing sessions and roles for students as teachers, leaders, and collaborators. Third-year medical students serve as teaching assistants. With its clinical focus and competency-based design, the human structure block connects basic science with best-practice clinical medicine.

  1. Morbidity and Mortality Conference in Obstetrics and Gynecology: A Tool for Addressing the 6 Core Competencies

    PubMed Central

    Bevis, Kerri S; Straughn, J. Michael; Kendrick, James E; Walsh-Covarrubias, Julie; Kilgore, Larry C

    2011-01-01

    Background Residency program directors are challenged to effectively teach and assess the Accreditation Council for Graduate Medical Education's (ACGME) 6 competencies. The purpose of this study was to characterize the morbidity and mortality (M&M) conference as a cost-effective and efficient approach for addressing the ACGME competencies through evaluation of resident participation and case diversity. Methods In our modified M&M conference, senior residents submit a weekly list of cases to the conference proctors. The resident presents the case, including a critique of management, using the medical literature. The resident submits a case summary evaluating patient care practices, integrating scientific evidence, and evaluating systemic barriers to care. Completed case summaries are distributed and archived for reference. Results During a 3-year period, 30 residents presented 196 cases. Of these, 37 (19%) directly related to systems-based practice, 20 (10%) involved problems with inadequate communication, and 11 (6%) included issues of professionalism or ethics. All cases involved practice-based learning and medical knowledge. Conclusions The M&M conference addresses the core competencies through resident participation as well as directed analysis of diverse cases. PMID:22379530

  2. General Marketing. Ohio's Competency Analysis Profile. Revised.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Vocational Instructional Materials Lab.

    Developed through a modified DACUM (Developing a Curriculum) process involving business, industry, labor, and community agency representatives in Ohio, this document is a comprehensive and verified employer competency profile for general marketing occupations. The list contains units (with and without subunits), competencies, and competency…

  3. Early Impact of the 2011 ACGME Duty Hour Regulations on Surgical Outcomes

    PubMed Central

    Scally, Christopher P.; Ryan, Andrew M.; Thumma, Jyothi R.; Gauger, Paul G.; Dimick, Justin B.

    2015-01-01

    Background In 2011, the Accreditation Council for Graduate Medical Education (ACGME) implemented additional restrictions on resident work hours. While the impact of these restrictions on the education of surgical trainees has been examined, the effect on patient safety remains poorly understood. Methods We used national Medicare Claims data for patients undergoing general (n = 1,223,815) and vascular (n = 475,262) surgery procedures in the 3 years preceding the duty hour changes (January, 2009 – June, 2011) and the 18 months following (July, 2011 - December, 2012). Hospitals were stratified into quintiles by teaching intensity using a resident to bed ratio. We utilized a difference-in-differences analytic technique, using non-teaching hospitals as a control group, to compare risk adjusted 30-day mortality, serious morbidity, readmission, and failure to rescue (FTR) rates before and after the duty hour changes. Results Following duty hour reform, no significant changes were seen in the measured outcomes when comparing teaching to non-teaching hospitals. Even when stratifying by teaching intensity there were no differences. For example, at the highest intensity teaching hospitals (resident/bed ratio ≥ .6), mortality rates before and after the duty hour changes were 4.2% and 4.0%, compared to 4.7% and 4.4% for non-teaching hospitals (RR .98, 95% CI .89-1.07). Similarly, serious complication (RR 1.02, 95% CI .98-1.06), FTR (RR .95, 95% CI .87-1.04), and readmission (OR 1.00, 95% CI .96-1.03) rates were unchanged. Conclusions In Medicare beneficiaries undergoing surgery at teaching hospitals, outcomes have not improved since the 2011 ACGME duty hour regulations. PMID:26054323

  4. Medical education and the ACGME duty hour requirements: assessing the effect of a day float system on educational activities.

    PubMed

    Roey, Steve

    2006-01-01

    In July 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted new resident work hour mandates, which are being shown to improve resident well-being and patient safety. However, there are limited data on the impact these new mandates may have on educational activities. To assess the impact on educational activities of a day float system created to meet ACGME work hour mandates. The inpatient ward coverage was changed by adding a day float team responsible for new patient admissions in the morning, with the on-call teams starting later and being responsible for new patient admissions thereafter. I surveyed the residents to assess the impact of this new system on educational activities-resident autonomy, attending teaching, conference attendance, resident teaching, self-directed learning, and ability to complete patient care responsibilities. There was no adverse effect of the day float system on educational activities. House staff reported increased autonomy, enhanced teaching from attending physicians, and improved ability to complete patient care responsibilities. Additionally, house staff demonstrated improved compliance with the ACGME mandates. The implementation of a novel day float system for the inpatient medicine ward service improved compliance with ACGME work duty requirements and did not adversely impact educational activities of the residency training program.

  5. General Office/Typist: Task List Competency Record.

    ERIC Educational Resources Information Center

    Minnesota Instructional Materials Center, White Bear Lake.

    One of 12 in the secretarial/clerical area, this booklet for the vocational instructor contains a job description for the general office typist, a task list of areas of competency, an occupational tasks competency record (suggested as replacement for the traditional report card), a list of industry representatives and educators involved in…

  6. Graduate Medical Education Specialty Mix and Geographic Residency Program Maldistribution: Is There a Role for the ACGME?

    PubMed

    Nasca, Thomas J; Carlson, Douglas

    2016-03-01

    As we've stated, GME is the final common pathway toward clinical medical practice in the US. It makes sense, then, that national physician workforce policy aimed at meeting future public health demands should be directed at this phase of medical education. It would also make sense that ACGME, as the single accreditor of all residency programs in the US, should be engaged in physician workforce policymaking on behalf of the public. We identified three issues that must be addressed in order for the ACGME to assume this role: First, there must be a national agreed-upon and long-term plan for the design and implementation of the health care delivery system. Second, there must be a nationally coordinated strategy for identifying long-term physician workforce needs and funding mechanisms to physician and other health care professional developments. Third, in order to execute these roles, the ACGME must receive support from the profession and national and state-level statutory protection from enforcement of state and federal antitrust law.

  7. The research rotation: competency-based structured and novel approach to research training of internal medicine residents.

    PubMed

    Kanna, Balavenkatesh; Deng, Changchun; Erickson, Savil N; Valerio, Jose A; Dimitrov, Vihren; Soni, Anita

    2006-10-17

    In the United States, the Accreditation Council of graduate medical education (ACGME) requires all accredited Internal medicine residency training programs to facilitate resident scholarly activities. However, clinical experience and medical education still remain the main focus of graduate medical education in many Internal Medicine (IM) residency-training programs. Left to design the structure, process and outcome evaluation of the ACGME research requirement, residency-training programs are faced with numerous barriers. Many residency programs report having been cited by the ACGME residency review committee in IM for lack of scholarly activity by residents. We would like to share our experience at Lincoln Hospital, an affiliate of Weill Medical College Cornell University New York, in designing and implementing a successful structured research curriculum based on ACGME competencies taught during a dedicated "research rotation". Since the inception of the research rotation in 2004, participation of our residents among scholarly activities has substantially increased. Our residents increasingly believe and appreciate that research is an integral component of residency training and essential for practice of medicine. Internal medicine residents' outlook in research can be significantly improved using a research curriculum offered through a structured and dedicated research rotation. This is exemplified by the improvement noted in resident satisfaction, their participation in scholarly activities and resident research outcomes since the inception of the research rotation in our internal medicine training program.

  8. The research rotation: competency-based structured and novel approach to research training of internal medicine residents

    PubMed Central

    Kanna, Balavenkatesh; Deng, Changchun; Erickson, Savil N; Valerio, Jose A; Dimitrov, Vihren; Soni, Anita

    2006-01-01

    Background In the United States, the Accreditation Council of graduate medical education (ACGME) requires all accredited Internal medicine residency training programs to facilitate resident scholarly activities. However, clinical experience and medical education still remain the main focus of graduate medical education in many Internal Medicine (IM) residency-training programs. Left to design the structure, process and outcome evaluation of the ACGME research requirement, residency-training programs are faced with numerous barriers. Many residency programs report having been cited by the ACGME residency review committee in IM for lack of scholarly activity by residents. Methods We would like to share our experience at Lincoln Hospital, an affiliate of Weill Medical College Cornell University New York, in designing and implementing a successful structured research curriculum based on ACGME competencies taught during a dedicated "research rotation". Results Since the inception of the research rotation in 2004, participation of our residents among scholarly activities has substantially increased. Our residents increasingly believe and appreciate that research is an integral component of residency training and essential for practice of medicine. Conclusion Internal medicine residents' outlook in research can be significantly improved using a research curriculum offered through a structured and dedicated research rotation. This is exemplified by the improvement noted in resident satisfaction, their participation in scholarly activities and resident research outcomes since the inception of the research rotation in our internal medicine training program. PMID:17044924

  9. Resident Self-Assessment and Learning Goal Development: Evaluation of Resident-Reported Competence and Future Goals.

    PubMed

    Li, Su-Ting T; Paterniti, Debora A; Tancredi, Daniel J; Burke, Ann E; Trimm, R Franklin; Guillot, Ann; Guralnick, Susan; Mahan, John D

    2015-01-01

    To determine incidence of learning goals by competency area and to assess which goals fall into competency areas with lower self-assessment scores. Cross-sectional analysis of existing deidentified American Academy of Pediatrics' PediaLink individualized learning plan data for the academic year 2009-2010. Residents self-assessed competencies in the 6 Accreditation Council for Graduate Medical Education (ACGME) competency areas and wrote learning goals. Textual responses for goals were mapped to 6 ACGME competency areas, future practice, or personal attributes. Adjusted mean differences and associations were estimated using multiple linear and logistic regression. A total of 2254 residents reported 6078 goals. Residents self-assessed their systems-based practice (51.8) and medical knowledge (53.0) competencies lowest and professionalism (68.9) and interpersonal and communication skills (62.2) highest. Residents were most likely to identify goals involving medical knowledge (70.5%) and patient care (50.5%) and least likely to write goals on systems-based practice (11.0%) and professionalism (6.9%). In logistic regression analysis adjusting for postgraduate year (PGY), gender, and degree type (MD/DO), resident-reported goal area showed no association with the learner's relative self-assessment score for that competency area. In the conditional logistic regression analysis, with each learner serving as his or her own control, senior residents (PGY2/3+s) who rated themselves relatively lower in a competency area were more likely to write a learning goal in that area than were PGY1s. Senior residents appear to develop better skills and/or motivation to explicitly turn self-assessed learning gaps into learning goals, suggesting that individualized learning plans may help improve self-regulated learning during residency. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  10. Causes of Death of Residents in ACGME-Accredited Programs 2000 Through 2014: Implications for the Learning Environment.

    PubMed

    Yaghmour, Nicholas A; Brigham, Timothy P; Richter, Thomas; Miller, Rebecca S; Philibert, Ingrid; Baldwin, DeWitt C; Nasca, Thomas J

    2017-07-01

    To systematically study the number of U.S. resident deaths from all causes, including suicide. The more than 9,900 programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) annually report the status of residents. The authors aggregated ACGME data on 381,614 residents in training during years 2000 through 2014. Names of residents reported as deceased were submitted to the National Death Index to learn causes of death. Person-year calculations were used to establish resident death rates and compare them with those in the general population. Between 2000 and 2014, 324 individuals (220 men, 104 women) died while in residency. The leading cause of death was neoplastic disease, followed by suicide, accidents, and other diseases. For male residents the leading cause was suicide, and for female residents, malignancies. Resident death rates were lower than in the age- and gender-matched general population. Temporal patterns showed higher rates of death early in residency. Deaths by suicide were higher early in training, and during the first and third quarters of the academic year. There was no upward or downward trend in resident deaths over the 15 years of this study. Neoplastic disease and suicide were the leading causes of death in residents. Data for death by suicide suggest added risk early in residency and during certain months of the academic year. Providing trainees with a supportive environment and with medical and mental health services is integral to reducing preventable deaths and fostering a healthy physician workforce.

  11. The transition to competency-based pediatric training in the United Arab Emirates.

    PubMed

    Ibrahim, Halah; Al Tatari, Hossam; Holmboe, Eric S

    2015-04-01

    Although competency-based medical education has become the standard for physician training in the West, many developing countries have not yet adopted competency-based training. In 2009 in the United Arab Emirates, the government regulatory and operational authorities for healthcare in Abu Dhabi mandated a wide-scale reform of the emirate's postgraduate residency programs to the competency-based framework of the newly formed Accreditation Council for Graduate Medical Education-International (ACGME-I). This article briefly describes the rationale for competency-based medical education and provides an overview of the transition from traditional, time-based residency training to competency-based postgraduate medical education for the Pediatrics residency programs in Abu Dhabi. We will provide data on the initial impact of this transition on resident performance and patient outcomes in a Pediatrics residency program in an academic medical center in the United Arab Emirates.

  12. What Indicates Competency in Systems Based Practice? An Analysis of Perspective Consistency among Healthcare Team Members

    ERIC Educational Resources Information Center

    Graham, Mark J.; Naqvi, Zoon; Encandela, John A.; Bylund, Carma L.; Dean, Randa; Calero-Breckheimer, Ayxa; Schmidt, Hilary J.

    2009-01-01

    In many parts of the world the practice of medicine and medical education increasingly focus on providing patient care within context of the larger healthcare system. Our purpose is to solicit perceptions of all professional stakeholders (e.g. nurses) of the system regarding the U.S. ACGME competency Systems Based Practice to uncover the extent to…

  13. Systems-based practice: the sixth core competency.

    PubMed

    Dyne, Pamela L; Strauss, Robert W; Rinnert, Stephan

    2002-11-01

    Systems-Based Practice (SBP) is the sixth competency defined by the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project. Specifically, SBP requires "Residents [to] demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value." This competency can be divided into four subcompetencies, all of which are integral to training emergency medicine (EM) physicians: resources, providers, and systems; cost-appropriate care; delivery systems; and patient advocacy. In March 2002, the Council of Emergency Medicine Residency Directors (CORD-EM) convened a consensus conference to assist residency directors in modifying the SBP competency specific for EM. The Consensus Group modified the broad ACGME definition for SBP into EM-specific goals and objectives for residency training in SBP. The primary assessment methods from the Toolbox of Assessment Methods were also identified for SBP. They are direct observation, global ratings, 360-degree evaluations, portfolio assessment, and testing by both oral and written exams. The physician tasks from the Model of the Clinical Practice of Emergency Medicine that are most relevant to SBP are out-of-hospital care, modifying factors, legal/professional issues, diagnostic studies, consultation and disposition, prevention and education, multitasking, and team management. Suggested EM residency curriculum components for SBP are already in place in most residency programs, so no additional resources would be required for their implementation. These include: emergency medical services and administrative rotations, directed reading, various interdisciplinary and hospital committee participation, continuous quality improvement project participation, evidence-based medicine instruction, and various didactic experiences, including follow-up, interdisciplinary, and case conferences. With appropriate

  14. Otolaryngology Resident Education and the Accreditation Council for Graduate Medical Education Core Competencies: A Systematic Review.

    PubMed

    Faucett, Erynne A; Barry, Jonnae Y; McCrary, Hilary C; Saleh, Ahlam A; Erman, Audrey B; Ishman, Stacey L

    2018-04-01

    To date, there have been no reports in the current literature regarding the use of the Accreditation Council for Graduate Medical Education (ACGME) core competencies in otolaryngology residency training. An evaluation may help educators address these core competencies in the training curriculum. To examine the quantity and nature of otolaryngology residency training literature through a systematic review and to evaluate whether this literature aligns with the 6 core competencies. A medical librarian assisted in a search of all indexed years of the PubMed, Embase, Education Resources Information Center (via EBSCOhost), Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Cochrane Methodology Register), Thomson Reuters Web of Science (Science Citation Index Expanded, Social Sciences Citation Index Expanded, Conference Proceedings Citation Index-Science, and Conference Proceedings Citation Index-Social Science and Humanities), Elsevier Scopus, and ClinicalTrials.gov databases to identify relevant English-language studies. Included studies contained original human data and focused on otolaryngology resident education. Data regarding study design, setting, and ACGME core competencies addressed were extracted from each article. Initial searches were performed on May 20, 2015, and updated on October 4, 2016. In this systematic review of 104 unique studies, interpersonal communication skills were reported 15 times; medical knowledge, 48 times; patient care, 44 times; practice-based learning and improvement, 31 times; professionalism, 15 times; and systems-based practices, 10 times. Multiple studies addressed more than 1 core competency at once, and 6 addressed all 6 core competencies. Increased emphasis on nonclinical core competencies is needed, including professionalism, interpersonal and communication skills, and systems-based practices in the otolaryngology residency training curriculum. A formal curriculum

  15. A novel Web-based graduate medical education management system including ACGME compliance algorithms.

    PubMed

    Gauger, Paul G; Davis, Janice W; Orr, Peter J

    2002-09-01

    Administration of graduate medical education programs has become more difficult as compliance with ACGME work guidelines has assumed increased importance. These guidelines have caused many changes in the resident work environment, including the emergence of complicated cross-cover arrangements. Many participating residents (each with his or her own individual scheduling requirements) usually generate these schedules. Accordingly, schedules are often not submitted in a timely fashion and they may not be in compliance with the ACGME guidelines for maximum on-call assignments and mandatory days off. Our objective was the establishment of a Web-based system that guides residents in creating on-call schedules that follow ACGME guidelines while still allowing maximum flexibility -- thus allowing each resident to maintain an internal locus of control. A versatile and scalable system with password-protected user (resident) and administrator interfaces was created. An entire academic year is included, and past months and years are automatically archived. The residents log on within the first 15 days of the preceding month and choose their positions in a schedule template. They then make adjustments while receiving immediate summary feedback on compliance with ACGME guidelines. The schedule is electronically submitted to the educational administrator for final approval. If a cross-cover system is required, the program automatically generates an optimal schedule using both of the approved participating service schedules. The residents then have an additional five-day period to make adjustments in the cross-cover schedule while still receiving compliance feedback. The administrator again provides final approval electronically. The communication interface automatically pages or e-mails the residents when schedules are updated or approved. Since the information exists in a relational database, simple reporting tools are included to extract the information necessary to generate

  16. Developing Common Competencies for Southeast Asian General Dental Practitioners.

    PubMed

    Chuenjitwongsa, Supachai; Poolthong, Suchit; Bullock, Alison; Oliver, Richard G

    2017-09-01

    Current policy in Southeast Asian dental education focuses on high-quality dental services from new dental graduates and the free movement of dental practitioners across the region. The Southeast Asian Nations (ASEAN) Dental Councils have proposed the "Common Major Competencies for ASEAN General Dental Practitioners" to harmonize undergraduate dental education. This article discusses how the ASEAN competencies were developed and established to assist the development of general dental practitioners with comparable knowledge, skills, and attitudes across ASEAN. The competencies were developed through four processes: a questionnaire about current national oral health problems, a two-round Delphi process that sought agreement on competencies, a panel discussion by representatives from ASEAN Dental Councils, and data verification by the representatives after the meeting. Key themes of the ASEAN competencies were compared with the competencies from the U.S., Canada, Europe, Australia, and Japan. A total of 33 competency statements, consistent with other regions, were agreed upon and approved. Factors influencing the ASEAN competencies and their implementation include oral health problems in ASEAN, new knowledge and technology in dentistry, limited institutional resources, underregulated dental schools, and uneven distribution of dental practitioners. The ASEAN competencies will serve as the foundation for further developments in ASEAN dental education including policy development, curriculum revision, quality assurance, and staff development. Collaboration amongst stakeholders is essential for successful harmonization of ASEAN dental education.

  17. Desired General Education Competencies: A Corporate Perspective.

    ERIC Educational Resources Information Center

    Meyer, Rita; And Others

    A corporate perspective on the general education competencies expected of middle management and technical personnel is provided and responded to in these three papers. First, Rita Meyer presents results from a study conducted by West Virginia Northern Community College to obtain the views of corporate managers on the general education…

  18. Changes to pediatric clerkships' nighttime structure after introduction of the 2011 ACGME resident duty hour standards.

    PubMed

    Smith, Andrew; Stevenson, Adam

    2014-01-01

    To report changes in pediatric clerkship nighttime clinical structures before and after implementation of the 2011 Accreditation Council for Graduate Medical Education (ACGME) resident duty hour standards. As part of the 2011 Council on Medical Student Education in Pediatrics (COMSEP) member annual survey, we surveyed leaders of pediatric undergraduate medical education on their medical school's current nighttime clinical structure, changes in nighttime structure between 2010 and 2011, and their school's student duty hour standards. Fifty-six percent (n = 83) of Liaison Committee for Medical Education (LCME)-accredited medical schools responded to the survey. Of received responses, 98% of pediatric clerkships have some form of nighttime clinical experience; 49% of clerkships have medical students stay late, 24% of clerkships utilize night shifts, and 16% use a traditional call structure. Forty-five percent of clerkships report changing their nighttime clinical experience after implementation of the 2011 ACGME duty hour standards; 46% of clerkships that changed had previously used traditional call. Seventy-six percent of clerkships report having medical student duty hour standards at their medical school. The majority of pediatric clerkships in our survey include nighttime clinical experiences in their curriculum, although variability exists in the type of structure. Additionally, the new ACGME duty hour standards appear to affect clerkships directors' choice of structure. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  19. An ACGME Duty Hour Compliant 3-Person Night Float System for Neurological Surgery Residency Programs.

    PubMed

    Ragel, Brian T; Piedra, Mark; Klimo, Paul; Burchiel, Kim J; Waldo, Heidi; McCartney, Shirley; Selden, Nathan R

    2014-06-01

    In 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted the 24+6-hour work schedule and 80-hour workweek, and in 2011, it enhanced work hour and supervision standards. In response, Oregon Health & Science University's (OHSU) neurological surgery residency instituted a 3-person night float system. We analyzed work hour records and operative experience for 1 year before and after night float implementation in a model that shortened a combined introductory research and basic clinical neurosciences rotation from 12 to 6 months. We analyzed residents' perception of the system using a confidential survey. The ACGME 2011 work hour standards were applied to both time periods. AFTER NIGHT FLOAT IMPLEMENTATION, THE NUMBER OF DUTY HOUR VIOLATIONS WAS REDUCED: 28-hour shift (11 versus 235), 8 hours off between shifts (2 versus 20), 80 hours per week (0 versus 17), and total violations (23 versus 275). Violations increased only for the less than 4 days off per 4-week interval rule (10 versus 3). No meaningful difference was seen in the number of operative cases performed per year at any postgraduate year (PGY) training level: PGY-2 (336 versus 351), PGY-3 (394 versus 354), PGY-4 (803 versus 802), PGY-5 (1075 versus 1040), PGY-7 (947 versus 913), and total (3555 versus 3460). Residents rated the new system favorably. To meet 2011 ACGME duty hour standards, the OHSU neurological surgery residency instituted a 3-person night float system. A nearly complete elimination of work hour violations did not affect overall resident operative experience.

  20. Using the Affective Domain to Enhance Teaching of the ACGME Competencies in Anesthesiology Training.

    PubMed

    Yanofsky, Samuel D; Nyquist, Julie G

    2010-01-01

    Teaching and assessing the advanced competencies will continue to be a challenge. Incorporating new and nontraditional skills into an already complex and challenging clinical curriculum and practice is not easy. This makes development of methods for curricular design, teaching and assessment of anesthesiology resident and fellow performance essential. The Domains of learning, particularly the Affective Domain can serve as an organizing structure for developing objectives and selecting teaching and assessment techniques. Using the Affective Domain to select targeted teaching techniques might help foster development of key beliefs and values that underlie the advanced competencies (and sub-competencies). Targeted teaching, outside of the patient care arena, when combined with traditional clinical teaching practices, may help to ensure continued performance of desired behaviors. These include acting in a consultative role for other health professionals (ICS), providing culturally responsive care (Professionalism), using evidence to enhance the care of patients (PBLI), and advocating for quality of care and working to enhance patient safety (SBP). As educators, our aim is not only to impact knowledge, attitudes and skills, but to impact the daily behavior of our graduates.

  1. [A competency model of rural general practitioners: theory construction and empirical study].

    PubMed

    Yang, Xiu-Mu; Qi, Yu-Long; Shne, Zheng-Fu; Han, Bu-Xin; Meng, Bei

    2015-04-01

    To perform theory construction and empirical study of the competency model of rural general practitioners. Through literature study, job analysis, interviews, and expert team discussion, the questionnaire of rural general practitioners competency was constructed. A total of 1458 rural general practitioners were surveyed by the questionnaire in 6 central provinces. The common factors were constructed using the principal component method of exploratory factor analysis and confirmatory factor analysis. The influence of the competency characteristics on the working performance was analyzed using regression equation analysis. The Cronbach 's alpha coefficient of the questionnaire was 0.974. The model consisted of 9 dimensions and 59 items. The 9 competency dimensions included basic public health service ability, basic clinical skills, system analysis capability, information management capability, communication and cooperation ability, occupational moral ability, non-medical professional knowledge, personal traits and psychological adaptability. The rate of explained cumulative total variance was 76.855%. The model fitting index were Χ(2)/df 1.88, GFI=0.94, NFI=0.96, NNFI=0.98, PNFI=0.91, RMSEA=0.068, CFI=0.97, IFI=0.97, RFI=0.96, suggesting good model fitting. Regression analysis showed that the competency characteristics had a significant effect on job performance. The rural general practitioners competency model provides reference for rural doctor training, rural order directional cultivation of medical students, and competency performance management of the rural general practitioners.

  2. Establishing a General Framework Civic Competency for European Youth

    ERIC Educational Resources Information Center

    Chow, Joseph

    2012-01-01

    This paper proposes a project that aims to construct a general framework of civic competency that will help understand civic competence as a blended measure of civic knowledge, skills, attitudes, values, beliefs, behavioural intentions and behaviours. By distinguishing between civic potential, civic behaviour and civic outcomes, with empirical…

  3. ACGME case logs: Surgery resident experience in operative trauma for two decades

    PubMed Central

    Drake, Frederick Thurston; Van Eaton, Erik G.; Huntington, Ciara R.; Jurkovich, Gregory J.; Aarabi, Shahram; Gow, Kenneth W.

    2014-01-01

    BACKGROUND Surgery resident education is based on experiential training, which is influenced by changes in clinical management strategies, technical and technologic advances, and administrative regulations. Trauma care has been exposed to each of these factors, prompting concerns about resident experience in operative trauma. The current study analyzed the reported volume of operative trauma for the last two decades; to our knowledge, this is the first evaluation of nationwide trends during such an extended time line. METHODS The Accreditation Council for Graduate Medical Education (ACGME) database of operative logs was queried from academic year (AY) 1989–1990 to 2009–2010 to identify shifts in trauma operative experience. Annual case log data for each cohort of graduating surgery residents were combined into approximately 5-year blocks, designated Period I (AY1989–1990 to AY1993–1994), Period II (AY1994–1995 to AY1998–1999), Period III (AY1999–2000 to AY2002–2003), and Period IV (AY2003–2004 to AY2009–2010). The latter two periods were delineated by the year in which duty hour restrictions were implemented. RESULTS Overall general surgery caseload increased from Period I to Period II (p < 0.001), remained stable from Period II to Period III, and decreased from Period III to Period IV (p < 0.001). However, for ACGME-designated trauma cases, there were significant declines from Period I to Period II (75.5 vs. 54.5 cases, p < 0.001) and Period II to Period III (54.5 vs. 39.3 cases, p < 0.001) but no difference between Period III and Period IV (39.3 vs. 39.4 cases). Graduating residents in Period I performed, on average, 31 intra-abdominal trauma operations, including approximately five spleen and four liver operations. Residents in Period IV performed 17 intra-abdominal trauma operations, including three spleen and approximately two liver operations. CONCLUSION Recent general surgery trainees perform fewer trauma operations than previous trainees

  4. Science of health care delivery milestones for undergraduate medical education.

    PubMed

    Havyer, Rachel D; Norby, Suzanne M; Leep Hunderfund, Andrea N; Starr, Stephanie R; Lang, Tara R; Wolanskyj, Alexandra P; Reed, Darcy A

    2017-08-25

    The changing healthcare landscape requires physicians to develop new knowledge and skills such as high-value care, systems improvement, population health, and team-based care, which together may be referred to as the Science of Health Care Delivery (SHCD). To engender public trust and confidence, educators must be able to meaningfully assess physicians' abilities in SHCD. We aimed to develop a novel set of SHCD milestones based on published Accreditation Council for Graduate Medical Education (ACGME) milestones that can be used by medical schools to assess medical students' competence in SHCD. We reviewed all ACGME milestones for 25 specialties available in September 2013. We used an iterative, qualitative process to group the ACGME milestones into SHCD content domains, from which SHCD milestones were derived. The SHCD milestones were categorized within the current ACGME core competencies and were also mapped to Association of American Medical Colleges' Entrustable Professional Activities (AAMC EPAs). Fifteen SHCD sub-competencies and corresponding milestones are provided, grouped within ACGME core competencies and mapped to multiple AAMC EPAs. This novel set of milestones, grounded within the existing ACGME competencies, defines fundamental expectations within SHCD that can be used and adapted by medical schools in the assessment of medical students in this emerging curricular area. These milestones provide a blueprint for SHCD content and assessment as ongoing revisions to milestones and curricula occur.

  5. Using the Affective Domain to Enhance Teaching of the ACGME Competencies in Anesthesiology Training

    PubMed Central

    2010-01-01

    Teaching and assessing the advanced competencies will continue to be a challenge. Incorporating new and nontraditional skills into an already complex and challenging clinical curriculum and practice is not easy. This makes development of methods for curricular design, teaching and assessment of anesthesiology resident and fellow performance essential. The Domains of learning, particularly the Affective Domain can serve as an organizing structure for developing objectives and selecting teaching and assessment techniques. Using the Affective Domain to select targeted teaching techniques might help foster development of key beliefs and values that underlie the advanced competencies (and sub-competencies). Targeted teaching, outside of the patient care arena, when combined with traditional clinical teaching practices, may help to ensure continued performance of desired behaviors. These include acting in a consultative role for other health professionals (ICS), providing culturally responsive care (Professionalism), using evidence to enhance the care of patients (PBLI), and advocating for quality of care and working to enhance patient safety (SBP). As educators, our aim is not only to impact knowledge, attitudes and skills, but to impact the daily behavior of our graduates. PMID:27175387

  6. Cost implications of ACGME's 2011 changes to resident duty hours and the training environment.

    PubMed

    Nuckols, Teryl K; Escarce, José J

    2012-02-01

    In July 2011, the Accreditation Council for Graduate Medical Education (ACGME) will implemented stricter duty-hour limits and related changes to the training environment. This may affect preventable adverse event (PAE) rates. To estimate direct costs under various implementation approaches, and examine net costs to teaching hospitals and cost-effectiveness to society across a range of hypothetical changes in PAEs. A decision-analytical model represented direct costs and PAE rates, mortality, and costs. Published literature and publicly available data. Patients admitted to hospitals with ACGME-accredited programs. One year. All teaching hospitals, major teaching hospitals, society. ACGME's 2011 Common Program Requirements. Direct annual costs (all accredited hospitals), net cost (major teaching hospitals), cost per death averted (society). RESULTS OF BASE-ANALYSIS: Nationwide, duty-hour changes would cost $177 million annually if interns maintain current productivity, vs. up to $982 million if they transfer work to a mixture of substitutes; training-environment changes will cost $204 million. If PAEs decline by 7.2-25.8%, net costs to major teaching hospitals will be zero. If PAEs fall by 3%, the cost to society per death averted would be -$523,000 (95%-confidence interval: -$1.82 million to $685,000) to $2.44 million ($271,000 to $6.91 million). If PAEs rise, the policy will be cost-increasing for teaching hospitals and society. The total direct annual cost nationwide would be up to $1.34 billion using nurse practitioners/physician assistants, $1.64 billion using attending physicians, $820 million hiring additional residents, vs. 1.42 billion using mixed substitutes. The effect on PAEs is unknown. Data were limited for some model parameters. Implementation decisions greatly affect the cost. Unless PAEs decline substantially, teaching hospitals will lose money. If PAEs decline modestly, the requirements might be cost-saving or cost-effective to society.

  7. The development of a cultural standardized patient examination for a general surgery residency program.

    PubMed

    Chun, Maria B J; Young, Keane G M; Honda, Andrea F; Belcher, Gary F; Maskarinec, Gregory G

    2012-01-01

    Cultural competency and cross-cultural care issues in surgery resident education are areas of recognized need. The Accreditation Council for Graduate Medical Education (ACGME) has developed 6 core competencies addressing training to provide high quality care. Of these, cultural training is addressed under 3: patient care, professionalism, and interpersonal and communication skills. Our study sought to develop a measurable tool-a cultural standardized patient (SP) examination-that integrates cross-cultural care issues within the core competencies. All first year surgery residents (PGY-1) were required to participate in the videotaped cultural SP examination as part of the general surgery residency curriculum. Two measures were utilized to assess resident performance. On the same day, we administered a Cross-Cultural Care Survey. The SP examination was assessed by trained surgery teaching faculty using a written checklist that was developed to evaluate residents on all 6 ACGME competencies. Of the 26 eligible participants over 2 years, we were able to analyze the pre- and post-test results for 24 residents. The post-test score of the "attitude toward cross-cultural care" subscale of the Cross-Cultural Care Survey was significantly lower than the pre-test score (p = 0.012; Wilcoxon signed-ranks test). There were significant differences by ethnicity on all 3 subscales of the Cross-Cultural Care Survey (attitude = p < 0.05, knowledge = p < 0.01, skills = p < 0.05) on the pre-test. However, only the knowledge subscale scores remained significantly different between ethnicities on the post-test (p < 0.01). After additional assessment, evaluation, and refinement, our goal is to incorporate cross-cultural health care training as a permanent part of our curriculum. Our hope is that efforts to provide training in cross-cultural healthcare leads to high quality care and positive outcomes for the patient. This will not only enhance our training program, but may also become a

  8. ACGME Duty Hour Requirements: Perceptions and Impact on Resident Training and Patient Care.

    PubMed

    Levine, William N; Spang, Robert C

    2014-09-01

    In 2003, the Accreditation Council for Graduate Medical Education (ACGME) created national guidelines for resident work hours to promote safe care and high-quality learning. However, some reports suggested that the 2003 rules did not reduce resident fatigue or improve patient care. Since July 2011, further restrictions have been in effect. The changes have been the source of much controversy regarding their impact on resident education and patient safety. We reviewed existing literature on the effects of the new and old rules, with a focus on the field of orthopaedics. In addition, we conducted a national survey of orthopaedic residents and residency directors to assess the general opinions of the orthopaedic community. Overall, only 19.7% of all respondents were satisfied with the new 2011 regulations, whereas 58.9% believe the 80-hour work week averaged over 4 weeks is appropriate. The results will inform discussions and decisions related to changing residency education in the future. Copyright 2014 by the American Academy of Orthopaedic Surgeons.

  9. The Impact of 2011 ACGME Duty Hour Restrictions on Internal Medicine Resident Workload and Education

    ERIC Educational Resources Information Center

    Vucicevic, Darko; Mookadam, Farouk; Webb, Brandon J.; Labonte, Helene R.; Cha, Stephen S.; Blair, Janis E.

    2015-01-01

    The Accreditation Council for Graduate Medical Education (ACGME) implemented work hour restrictions for physicians in training in 2003 that were revised July 1, 2011. Current published data are insufficient to assess whether such work hour restrictions will have long-term impact on residents' education. We searched computer-generated reports…

  10. Summary of ACOP (American College of Osteopathic Pediatricians) Program Directors' Annual Reports for First-Year Residents and Relationships between Resident Competency Performance Ratings and COMLEX-USA Test Scores

    ERIC Educational Resources Information Center

    Langenau, Erik E.; Pugliano, Gina; Roberts, William L.; Hostoffer, Robert

    2010-01-01

    Context: The Accreditation Council for Graduate Medical Education (ACGME) and American Osteopathic Association (AOA) endorsed the use of competency-based assessment, with the intention to improve health care administration [1, 2]. High-stakes licensing exams, such as the Comprehensive Osteopathic Medical Licensing Examination -- USA (COMLEX-USA),…

  11. Miller's Pyramid and Core Competency Assessment: A Study in Relationship Construct Validity.

    PubMed

    Williams, Betsy White; Byrne, Phil D; Welindt, Dillon; Williams, Michael V

    2016-01-01

    Continuous professional development relies on the link between performance and an educational process aimed at improving knowledge and skill. One of the most broadly used frameworks for assessing skills is Miller's Pyramid. This Pyramid has a series of levels of achievement beginning with knowledge (at the base) and ending with routine application in the clinical setting. The purpose of this study was to determine the degree of convergence of two measurement methods, one based on Miller's framework, the second using the Accreditation Council for Graduate Medical Education/American Board of Medical Specialties (ACGME/ABMS) Core Competency framework. The data were gathered from the faculty of a large, Midwestern regional health care provider and hospital system. Data from 264 respondents were studied. The 360° data were from raters of physicians holding supervisory roles in the organization. The scale items were taken from an instrument that has been validated for both structure and known group prediction. The Miller scale was purposely built for this application. The questions were designed to describe each level of the model. The Miller scale was reduced to a single dimension. This result was then regressed on the items from the 360° item ratings. Results of a multivariate analysis of variance isolated a significant relationship between the Miller's Pyramid score and the competency items (P < 0.001). These findings demonstrate a relationship between measures based on Miller's framework and behavioral measures based on the ABMS/ACGME core competencies. Equally important is the finding that while they are related they are not identical. These findings have implications for continuous professional development programing design.

  12. The importance of cultural competency in general pediatrics.

    PubMed

    Brotanek, Jane M; Seeley, Christina E; Flores, Glenn

    2008-12-01

    There is a growing awareness of the importance of cultural competency in pediatrics. The authors review the most recent studies that examine the impact of cultural competency on general pediatric care, explore cultural beliefs and practices affecting clinical care, and describe culturally sensitive interventions designed to address racial/ethnic health disparities. The beneficial effects of cultural competency embrace health outcomes, quality of care, and patient satisfaction, while failure to consider language and culture can have serious adverse consequences for clinical care, including patient safety and healthcare access. A five-component model of cultural competency has been developed, and a growing literature details an array of normative cultural values, folk illnesses, parent beliefs/practices, and provider behaviors that can have a profound impact on pediatric care. Culturally sensitive interventions are being developed to lessen racial/ethnic health disparities. A goal for the pediatrician is to provide culturally competent healthcare by using trained medical interpreters with limited English-proficient families, being familiar with normative cultural values that affect the healthcare of commonly encountered racial/ethnic groups, and asking about folk illness beliefs and ethnomedical treatments.

  13. Tracking Residents Through Multiple Residency Programs: A Different Approach for Measuring Residents' Rates of Continuing Graduate Medical Education in ACGME-Accredited Programs.

    PubMed

    Byrne, Lauren M; Holt, Kathleen D; Richter, Thomas; Miller, Rebecca S; Nasca, Thomas J

    2010-12-01

    Increased focus on the number and type of physicians delivering health care in the United States necessitates a better understanding of changes in graduate medical education (GME). Data collected by the Accreditation Council for Graduate Medical Education (ACGME) allow longitudinal tracking of residents, revealing the number and type of residents who continue GME following completion of an initial residency. We examined trends in the percent of graduates pursuing additional clinical education following graduation from ACGME-accredited pipeline specialty programs (specialties leading to initial board certification). Using data collected annually by the ACGME, we tracked residents graduating from ACGME-accredited pipeline specialty programs between academic year (AY) 2002-2003 and AY 2006-2007 and those pursuing additional ACGME-accredited training within 2 years. We examined changes in the number of graduates and the percent of graduates continuing GME by specialty, by type of medical school, and overall. The number of pipeline specialty graduates increased by 1171 (5.3%) between AY 2002-2003 and AY 2006-2007. During the same period, the number of graduates pursuing additional GME increased by 1059 (16.7%). The overall rate of continuing GME increased each year, from 28.5% (6331/22229) in AY 2002-2003 to 31.6% (7390/23400) in AY 2006-2007. Rates differed by specialty and for US medical school graduates (26.4% [3896/14752] in AY 2002-2003 to 31.6% [4718/14941] in AY 2006-2007) versus international medical graduates (35.2% [2118/6023] to 33.8% [2246/6647]). The number of graduates and the rate of continuing GME increased from AY 2002-2003 to AY 2006-2007. Our findings show a recent increase in the rate of continued training for US medical school graduates compared to international medical graduates. Our results differ from previously reported rates of subspecialization in the literature. Tracking individual residents through residency and fellowship programs provides

  14. Tracking Residents Through Multiple Residency Programs: A Different Approach for Measuring Residents' Rates of Continuing Graduate Medical Education in ACGME-Accredited Programs

    PubMed Central

    Byrne, Lauren M.; Holt, Kathleen D.; Richter, Thomas; Miller, Rebecca S.; Nasca, Thomas J.

    2010-01-01

    Background Increased focus on the number and type of physicians delivering health care in the United States necessitates a better understanding of changes in graduate medical education (GME). Data collected by the Accreditation Council for Graduate Medical Education (ACGME) allow longitudinal tracking of residents, revealing the number and type of residents who continue GME following completion of an initial residency. We examined trends in the percent of graduates pursuing additional clinical education following graduation from ACGME-accredited pipeline specialty programs (specialties leading to initial board certification). Methods Using data collected annually by the ACGME, we tracked residents graduating from ACGME-accredited pipeline specialty programs between academic year (AY) 2002–2003 and AY 2006–2007 and those pursuing additional ACGME-accredited training within 2 years. We examined changes in the number of graduates and the percent of graduates continuing GME by specialty, by type of medical school, and overall. Results The number of pipeline specialty graduates increased by 1171 (5.3%) between AY 2002–2003 and AY 2006–2007. During the same period, the number of graduates pursuing additional GME increased by 1059 (16.7%). The overall rate of continuing GME increased each year, from 28.5% (6331/22229) in AY 2002–2003 to 31.6% (7390/23400) in AY 2006–2007. Rates differed by specialty and for US medical school graduates (26.4% [3896/14752] in AY 2002–2003 to 31.6% [4718/14941] in AY 2006–2007) versus international medical graduates (35.2% [2118/6023] to 33.8% [2246/6647]). Conclusion The number of graduates and the rate of continuing GME increased from AY 2002–2003 to AY 2006–2007. Our findings show a recent increase in the rate of continued training for US medical school graduates compared to international medical graduates. Our results differ from previously reported rates of subspecialization in the literature. Tracking individual

  15. Teaching hospital financial status and patient outcomes following ACGME duty hour reform.

    PubMed

    Navathe, Amol S; Silber, Jeffrey H; Small, Dylan S; Rosen, Amy K; Romano, Patrick S; Even-Shoshan, Orit; Wang, Yanli; Zhu, Jingsan; Halenar, Michael J; Volpp, Kevin G

    2013-04-01

    To examine whether hospital financial health was associated with differential changes in outcomes after implementation of 2003 ACGME duty hour regulations. Observational study of 3,614,174 Medicare patients admitted to 869 teaching hospitals from July 1, 2000 to June 30, 2005. Interrupted time series analysis using logistic regression to adjust for patient comorbidities, secular trends, and hospital site. Outcomes included 30-day mortality, AHRQ Patient Safety Indicators (PSIs), failure-to-rescue (FTR) rates, and prolonged length of stay (PLOS). All eight analyses measuring the impact of duty hour reform on mortality by hospital financial health quartile, in postreform year 1 ("Post 1") or year 2 ("Post 2") versus the prereform period, were insignificant: Post 1 OR range 1.00-1.02 and Post 2 OR range 0.99-1.02. For PSIs, all six tests showed clinically insignificant effect sizes. The FTR rate analysis demonstrated nonsignificance in both postreform years (OR 1.00 for both). The PLOS outcomes varied significantly only for the combined surgical sample in Post 2, but this effect was very small, OR 1.03 (95% CI 1.02, 1.04). The impact of 2003 ACGME duty hour reform on patient outcomes did not differ by hospital financial health. This finding is somewhat reassuring, given additional financial pressure on teaching hospitals from 2011 duty hour regulations. © Health Research and Educational Trust.

  16. Veterans Affairs general surgery service: the last bastion of integrated specialty care.

    PubMed

    Poteet, Stephen; Tarpley, Margaret; Tarpley, John L; Pearson, A Scott

    2011-11-01

    In a time of increasing specialization, academic training institutions provide a compartmentalized learning environment that often does not reflect the broad clinical experience of general surgery practice. This study aimed to evaluate the contribution of the Veterans Affairs (VA) general surgery surgical experience to both index Accreditation Council for Graduate Medical Education (ACGME) requirements and as a unique integrated model in which residents provide concurrent care of multiple specialty patients. Institutional review board approval was obtained for retrospective analysis of electronic medical records involving all surgical cases performed by the general surgery service from 2005 to 2009 at the Nashville VA. Over a 5-year span general surgery residents spent an average of 5 months on the VA general surgery service, which includes a postgraduate year (PGY)-5, PGY-3, and 2 PGY-1 residents. Surgeries involved the following specialties: surgical oncology, endocrine, colorectal, hepatobiliary, transplant, gastrointestinal laparoscopy, and elective and emergency general surgery. The surgeries were categorized according to ACGME index requirements. A total of 2,956 surgeries were performed during the 5-year period from 2005 through 2009. Residents participated in an average of 246 surgeries during their experience at the VA; approximately 50 cases are completed during the chief year. On the VA surgery service alone, 100% of the ACGME requirement was met for the following categories: endocrine (8 cases); skin, soft tissue, and breast (33 cases); alimentary tract (78 cases); and abdominal (88 cases). Approximately 50% of the ACGME requirement was met for liver, pancreas, and basic laparoscopic categories. The VA hospital provides an authentic, broad-based, general surgery training experience that integrates complex surgical patients simultaneously. Opportunities for this level of comprehensive care are decreasing or absent in many general surgery training

  17. The medical mission and modern cultural competency training.

    PubMed

    Campbell, Alex; Sullivan, Maura; Sherman, Randy; Magee, William P

    2011-01-01

    Culture has increasingly appreciated clinical consequences on the patient-physician relationship, and governing bodies of medical education are widely expanding educational programs to train providers in culturally competent care. A recent study demonstrated the value an international surgical mission in modern surgical training, while fulfilling the mandate of educational growth through six core competencies. This report further examines the impact of international volunteerism on surgical residents, and demonstrates that such experiences are particularly suited to education in cultural competency. Twenty-one resident physicians who participated in the inaugural Operation Smile Regan Fellowship were surveyed one year after their experiences. One hundred percent strongly agreed that participation in an international surgical mission was a quality educational experience and 94.7% deemed the experience a valuable part of their residency training. In additional to education in each of the ACGME core competencies, results demonstrate valuable training in cultural competence. A properly structured and proctored experience for surgical residents in international volunteerism is an effective instruction tool in the modern competency-based residency curriculum. These endeavors provide a unique understanding of the global burden of surgical disease, a deeper appreciation for global public health issues, and increased cultural sensitivity. A surgical mission experience should be widely available to surgery residents. Copyright © 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  18. An Apprenticeship Rotation Teaches Chief Residents Nontechnical Skills and ACGME Core Competencies.

    PubMed

    Kwakye, Gifty; Chen, Xiaodong Phoenix; Havens, Joaquim M; Irani, Jennifer L; Yule, Steven; Smink, Douglas S

    2015-01-01

    Traditionally, surgical training has used an apprenticeship model but has more recently moved to a service-based model, with groups of residents working with groups of attending surgeons. We developed an apprenticeship rotation to enhance one-on-one interaction between chief residents and selected faculty. We hypothesized that the apprenticeship rotation would be effective for teaching nontechnical skills (NTS) and core competencies. An apprenticeship rotation was created at a university-based surgery residency in which each chief resident selected a single attending surgeon with whom to work exclusively with for a 4-week period. Emphasis was placed on teaching intraoperative NTS as well as the 4 difficult-to-teach Accreditation Council for Graduate Medical Education core competencies (DCC): Interpersonal and Communication Skills, Practice-Based Learning and Improvement, Professionalism, and Systems-Based Practice. Participants were surveyed afterwards about their rotation using a 5-point Likert scale. A Wilcoxon signed rank test was used to compare differences depending on data distribution. All (13/13) the chief residents and 67% (8/12) faculty completed the survey. Overall, 85% of residents and 87.5% of faculty would recommend the rotation to other residents/faculty members. Both residents and faculty reported improvement in trainees' technical skills and NTS. Residents reported improvement in all 4 DCC, particularly, Practice-Based Learning and Improvement, Professionalism, and Interpersonal and Communication Skills. The apprenticeship rotation is an effective means of teaching residents both NTS and DCC essential for independent practice. Consideration should be given to introducing this program into surgical curricula nationally. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. General practitioners' competence and confidentiality determinations with a minor who requests the oral contraceptive pill.

    PubMed

    Bartholomew, Terence P; Carvalho, Tatiana

    2005-11-01

    The right of minors to make medical treatment decisions is an issue that is not explicitly addressed in the legislation of most Australian jurisdictions. While recent common law decisions allow competent minors to consent to treatment, current legislation in Victoria does not provide adequate guidelines on how competence is to be measured. It is also unclear whether the duty of confidentiality is extended to competent minors. The current study explored general practitioners' competence and confidentiality decisions with a hypothetical 14-year-old patient who requests the oral contraceptive pill (OCP). Questionnaires were sent to 1,000 Victorian general practitioners, 305 of whom responded. General practitioners were asked to determine whether "Liz" was competent to request the OCP, and whether they would maintain her confidentiality. A total of 81% of respondents found the patient competent, while 91% would have maintained her confidentiality. Results indicate that the majority of general practitioners used rationales that generally did not conform to current legal principles when making competence and confidentiality determinations regarding this patient.

  20. Teaching Hospital Financial Status and Patient Outcomes Following ACGME Duty Hour Reform

    PubMed Central

    Navathe, Amol S; Silber, Jeffrey H; Small, Dylan S; Rosen, Amy K; Romano, Patrick S; Even-Shoshan, Orit; Wang, Yanli; Zhu, Jingsan; Halenar, Michael J; Volpp, Kevin G

    2013-01-01

    Objective To examine whether hospital financial health was associated with differential changes in outcomes after implementation of 2003 ACGME duty hour regulations. Data Sources/Study Setting Observational study of 3,614,174 Medicare patients admitted to 869 teaching hospitals from July 1, 2000 to June 30, 2005. Study Design Interrupted time series analysis using logistic regression to adjust for patient comorbidities, secular trends, and hospital site. Outcomes included 30-day mortality, AHRQ Patient Safety Indicators (PSIs), failure-to-rescue (FTR) rates, and prolonged length of stay (PLOS). Principal Findings All eight analyses measuring the impact of duty hour reform on mortality by hospital financial health quartile, in postreform year 1 (“Post 1”) or year 2 (“Post 2”) versus the prereform period, were insignificant: Post 1 OR range 1.00–1.02 and Post 2 OR range 0.99–1.02. For PSIs, all six tests showed clinically insignificant effect sizes. The FTR rate analysis demonstrated nonsignificance in both postreform years (OR 1.00 for both). The PLOS outcomes varied significantly only for the combined surgical sample in Post 2, but this effect was very small, OR 1.03 (95% CI 1.02, 1.04). Conclusions The impact of 2003 ACGME duty hour reform on patient outcomes did not differ by hospital financial health. This finding is somewhat reassuring, given additional financial pressure on teaching hospitals from 2011 duty hour regulations. PMID:22862427

  1. A Longitudinal, Experiential Quality Improvement Curriculum Meeting ACGME Competencies for Geriatrics Fellows: Lessons Learned

    ERIC Educational Resources Information Center

    Callahan, Kathryn E.; Rogers, Matthew T.; Lovato, James F.; Fernandez, Helen M.

    2013-01-01

    Quality improvement (QI) initiatives are critical in the care of older adults who are more vulnerable to substandard care. QI education meets aspects of core Accreditation Council of Graduate Medical Education competencies and prepares learners for the rising focus on performance measurement in health care. The authors developed, implemented, and…

  2. Surgical training, duty-hour restrictions, and implications for meeting the Accreditation Council for Graduate Medical Education core competencies: views of surgical interns compared with program directors.

    PubMed

    Antiel, Ryan M; Van Arendonk, Kyle J; Reed, Darcy A; Terhune, Kyla P; Tarpley, John L; Porterfield, John R; Hall, Daniel E; Joyce, David L; Wightman, Sean C; Horvath, Karen D; Heller, Stephanie F; Farley, David R

    2012-06-01

    To describe the perspectives of surgical interns regarding the implications of the new Accreditation Council for Graduate Medical Education (ACGME) duty-hour regulations for their training. We compared responses of interns and surgery program directors on a survey about the proposed ACGME mandates. Eleven general surgery residency programs. Two hundred fifteen interns who were administered the survey during the summer of 2011 and a previously surveyed national sample of 134 surgery program directors. Perceptions of the implications of the new duty-hour restrictions on various aspects of surgical training, including the 6 ACGME core competencies of graduate medical education, measured using 3-point scales (increase, no change, or decrease). Of 215 eligible surgical interns, 179 (83.3%) completed the survey. Most interns believed that the new duty-hour regulations will decrease continuity with patients (80.3%), time spent operating (67.4%), and coordination of patient care (57.6%), while approximately half believed that the changes will decrease their acquisition of medical knowledge (48.0%), development of surgical skills (52.8%), and overall educational experience (51.1%). Most believed that the changes will improve or will not alter other aspects of training, and 61.5% believed that the new standards will decrease resident fatigue. Surgical interns were significantly less pessimistic than surgery program directors regarding the implications of the new duty-hour restrictions on all aspects of surgical training (P < .05 for all comparisons). Although less pessimistic than program directors, interns beginning their training under the new paradigm of duty-hour restrictions have significant concerns about the effect of these regulations on the quality of their training.

  3. Perceptions of the 2011 ACGME duty hour requirements among residents in all core programs at a large academic medical center.

    PubMed

    Sandefur, Benjamin J; Shewmaker, Diana M; Lohse, Christine M; Rose, Steven H; Colletti, James E

    2017-11-10

    The Accreditation Council for Graduate Medical Education (ACGME) implemented revisions to resident duty hour requirements (DHRs) in 2011 to improve patient safety and resident well-being. Perceptions of DHRs have been reported to vary by training stage and specialty among internal medicine and general surgery residents. The authors explored perceptions of DHRs among all residents at a large academic medical center. The authors administered an anonymous cross-sectional survey about DHRs to residents enrolled in all ACGME-accredited core residency programs at their institution. Residents were categorized as medical and pediatric, surgery, or other. In total, 736 residents representing 24 core specialty residency programs were surveyed. The authors received responses from 495 residents (67%). A majority reported satisfaction (78%) with DHRs and believed DHRs positively affect their training (73%). Residents in surgical specialties and in advanced stages of training were significantly less likely to view DHRs favorably. Most respondents believed fatigue contributes to errors (89%) and DHRs reduce both fatigue (80%) and performance of clinical duties while fatigued (74%). A minority of respondents (37%) believed that DHRs decrease medical errors. This finding may reflect beliefs that handovers contribute more to errors than fatigue (41%). Negative perceived effects included diminished patient familiarity and continuity of care (62%) and diminished clinical educational experiences for residents (41%). A majority of residents reported satisfaction with the 2011 DHRs, although satisfaction was significantly less among residents in surgical specialties and those in advanced stages of training.

  4. The benefits of international rotations to resource-limited settings for U.S. surgery residents.

    PubMed

    Henry, Jaymie A; Groen, Reinou S; Price, Raymond R; Nwomeh, Benedict C; Kingham, T Peter; Hardy, Mark A; Kushner, Adam L

    2013-04-01

    U.S. surgery residents increasingly are interested in international experiences. Recently, the Residency Review Committee approved international surgery rotations for credit toward graduation. Despite this growing interest, few U.S. surgery residency programs offer formal international rotations. We aimed to present the benefits of international surgery rotations and how these rotations contribute to the attainment of the 6 Accreditation Council for Graduate Medical Education (ACGME) competencies. An e-mail-based survey was sent in November 2011 to the 188 members of Surgeons OverSeas, a group of surgeons, residents, fellows, and medical students with experience working in resource-limited settings. They were asked to list 5 benefits of international rotations for surgery residents. The frequency of benefits was qualitatively grouped into 4 major categories: educational, personal, benefits to the foreign institution/Global Surgery, and benefits to the home institution. The themes were correlated with the 6 ACGME competencies. The 58 respondents (31% response rate) provided a total of 295 responses. Fifty themes were identified. Top benefits included learning to optimally function with limited resources, exposure to a wide variety of operative pathology, exposure to a foreign culture, and forming relationships with local counterparts. All ACGME competencies were covered by the themes. International surgery rotations to locations in which resources are constrained, operative diseases vary, and patient diversity abound provide unique opportunities for surgery residents to attain the 6 ACGME competencies. General surgery residency programs should be encouraged to establish formal international rotations as part of surgery training to promote resident education and assist with necessary oversight. Copyright © 2013 Mosby, Inc. All rights reserved.

  5. Multi-institutional validation of a web-based core competency assessment system.

    PubMed

    Tabuenca, Arnold; Welling, Richard; Sachdeva, Ajit K; Blair, Patrice G; Horvath, Karen; Tarpley, John; Savino, John A; Gray, Richard; Gulley, Julie; Arnold, Teresa; Wolfe, Kevin; Risucci, Donald A

    2007-01-01

    The Association of Program Directors in Surgery and the Division of Education of the American College of Surgeons developed and implemented a web-based system for end-of-rotation faculty assessment of ACGME core competencies of residents. This study assesses its reliability and validity across multiple programs. Each assessment included ratings (1-5 scale) on 23 items reflecting the 6 core competencies. A total of 4241 end-of-rotation assessments were completed for 332 general surgery residents (> or =5 evaluations each) at 5 sites during the 2004-2005 and 2005-2006 academic years. The mean rating for each resident on each item was computed for each academic year. The mean rating of items representing each competency was computed for each resident. Additional data included USMLE and ABSITE scores, PGY, and status in program (categorical, designated preliminary, and undesignated preliminary). Coefficient alpha was greater than 0.90 for each competency score. Mean ratings for each competency increased significantly (p < 0.01) as a function of PGY. Mean ratings for professionalism and interpersonal/communication skills (IPC) were significantly higher than all other competencies at all PGY levels. Competency ratings of PGY 1 residents correlated significantly with USMLE Step I, ranging from (r = 0.26, p < 0.01) for Professionalism to (r = 0.41, p < 0.001) for Systems-Based Practice. Ratings of Knowledge (r = 0.31, p < 0.01), Practice-Based Learning & Improvement (PBLI; r = 0.22, p < 0.05), and Systems-Based Practice (r = 0.20, p < 0.05) correlated significantly with 2005 ABSITE Total Percentile. Ratings of all competencies correlated significantly with the 2006 ABSITE Total Percentile Score (range: r = 0.20, p < 0.05 for professionalism to r = 0.35, p < 0.001 for knowledge). Categorical and designated preliminary residents received significantly higher ratings (p < 0.05) than nondesignated preliminaries for knowledge, patient care, PBLI, and systems-based practice only

  6. Exploring Integration in Action: Competencies as Building Blocks of Expertise.

    PubMed

    Mylopoulos, Maria; Borschel, Debaroti Tina; O'Brien, Tara; Martimianakis, Sofia; Woods, Nicole N

    2017-12-01

    Competency frameworks such as the CanMEDS roles and the ACGME core competencies may lead to the implicit assumption that physicians can learn and practice individual competencies in isolation. In contrast, models of adaptive expertise suggest that the integration of competencies reflects the capabilities of an expert physician. Thus, educational programming aimed at teaching discrete roles or competencies might overlook expert physician capabilities that are central to patient care. To develop expertise, learning opportunities must reflect expert capabilities. To better understand the relationship between competency-based medical education and expert development, the authors sought to explore how integrated competencies are enacted during patient care by postgraduate medical trainees. Using a cognitive ethnographic approach, in 2014-2015 the authors conducted observations and-to refine and elaborate these observations-ad hoc informal interviews with 13 postgraduate trainee participants. Data collection resulted in 92 hours of observation, 26 patient case portraits, and a total of 220 pages of field notes for analysis. Through analysis, the authors identified and examined moments when postgraduate trainees appeared to be simultaneously enacting multiple competencies. The authors identified two key expert capabilities in moments of integrated competence: finding complexity and being patient-centered. They described two mechanisms for these forms of integration: valuing the patient's narrative of their illness, and integrated understanding. Understanding integrated competencies as the building blocks of expert capabilities, along with recognizing the importance of mechanisms that support integration, offers an opportunity to use existing competency-based frameworks to understand and teach adaptive expertise.

  7. Association of the 2011 ACGME resident duty hour reforms with mortality and readmissions among hospitalized Medicare patients.

    PubMed

    Patel, Mitesh S; Volpp, Kevin G; Small, Dylan S; Hill, Alexander S; Even-Shoshan, Orit; Rosenbaum, Lisa; Ross, Richard N; Bellini, Lisa; Zhu, Jingsan; Silber, Jeffrey H

    2014-12-10

    Patient outcomes associated with the 2011 Accreditation Council for Graduate Medical Education (ACGME) duty hour reforms have not been evaluated at a national level. To evaluate the association of the 2011 ACGME duty hour reforms with mortality and readmissions. Observational study of Medicare patient admissions (6,384,273 admissions from 2,790,356 patients) to short-term, acute care, nonfederal hospitals (n = 3104) with principal medical diagnoses of acute myocardial infarction, stroke, gastrointestinal bleeding, or congestive heart failure or a Diagnosis Related Group classification of general, orthopedic, or vascular surgery. Of the hospitals, 96 (3.1%) were very major teaching, 138 (4.4%) major teaching, 442 (14.2%) minor teaching, 443 (14.3%) very minor teaching, and 1985 (64.0%) nonteaching. Resident-to-bed ratio as a continuous measure of hospital teaching intensity. Change in 30-day all-location mortality and 30-day all-cause readmission, comparing patients in more intensive relative to less intensive teaching hospitals before (July 1, 2009-June 30, 2011) and after (July 1, 2011-June 30, 2012) duty hour reforms, adjusting for patient comorbidities, time trends, and hospital site. In the 2 years before duty hour reforms, there were 4,325,854 admissions with 288,422 deaths and 602,380 readmissions. In the first year after the reforms, accounting for teaching hospital intensity, there were 2,058,419 admissions with 133,547 deaths and 272,938 readmissions. There were no significant postreform differences in mortality accounting for teaching hospital intensity for combined medical conditions (odds ratio [OR], 1.00; 95% CI, 0.96-1.03), combined surgical categories (OR, 0.99; 95% CI, 0.94-1.04), or any of the individual medical conditions or surgical categories. There were no significant postreform differences in readmissions for combined medical conditions (OR, 1.00; 95% CI, 0.97-1.02) or combined surgical categories (OR, 1.00; 95% CI, 0.98-1.03). For the

  8. Creation of an emergency surgery service concentrates resident training in general surgical procedures.

    PubMed

    Ahmed, Hesham M; Gale, Stephen C; Tinti, Meredith S; Shiroff, Adam M; Macias, Aitor C; Rhodes, Stancie C; Defreese, Marissa A; Gracias, Vicente H

    2012-09-01

    Emergency general surgery (EGS) is increasingly being provided by academic trauma surgeons in an acute care surgery model. Our tertiary care hospital recently changed from a model where all staff surgeons (private, subspecialty academic, and trauma academic) were assigned EGS call to one in which an emergency surgery service (ESS), staffed by academic trauma faculty, cares for all EGS patients. In the previous model, many surgeries were "not covered" by residents because of work-hour restrictions, conflicting needs, or private surgeon preference. The ESS was separate from the trauma service. We hypothesize that by creating a separate ESS, residents can accumulate needed and concentrated operative experience in a well-supervised academic environment. A prospectively accrued EGS database was retrospectively queried for the 18-month period: July 2010 to June 2011. The Accreditation Council for Graduate Medical Education (ACGME) databases were queried for operative numbers for our residency program and for national resident data for 2 years before and after creating the ESS. The ACGME operative requirements were tabulated from online sources. ACGME requirements were compared with surgical cases performed. During the 18-month period, 816 ESS operations were performed. Of these, 307 (38%) were laparoscopy. Laparoscopic cholecystectomy and appendectomy were most common (138 and 145, respectively) plus 24 additional laparoscopic surgeries. Each resident performed, on average, 34 basic laparoscopic cases during their 2-month rotation, which is 56% of their ACGME basic laparoscopic requirement. A diverse mixture of 70 other general surgical operations was recorded for the remaining 509 surgical cases, including reoperative surgery, complex laparoscopy, multispecialty procedures, and seldom-performed operations such as surgery for perforated ulcer disease. Before the ESS, the classes of 2008 and 2009 reported that only 48% and 50% of cases were performed at the main academic

  9. Effect of Process Changes in Surgical Training on Quantitative Outcomes From Surgery Residency Programs.

    PubMed

    Dietl, Charles A; Russell, John C

    2016-01-01

    The purpose of this article is to review the literature on process changes in surgical training programs and to evaluate their effect on the Accreditation Council of Graduate Medical Education (ACGME) Core Competencies, American Board of Surgery In-Training Examination (ABSITE) scores, and American Board of Surgery (ABS) certification. A literature search was obtained from MEDLINE via PubMed.gov, ScienceDirect.com, Google Scholar on all peer-reviewed studies published since 2003 using the following search queries: surgery residency training, surgical education, competency-based surgical education, ACGME core competencies, ABSITE scores, and ABS pass rate. Our initial search list included 990 articles on surgery residency training models, 539 on competency-based surgical education, 78 on ABSITE scores, and 33 on ABS pass rate. Overall, 31 articles met inclusion criteria based on their effect on ACGME Core Competencies, ABSITE scores, and ABS certification. Systematic review showed that 5/31, 19/31, and 6/31 articles on process changes in surgical training programs had a positive effect on patient care, medical knowledge, and ABSITE scores, respectively. ABS certification was not analyzed. The other ACGME core competencies were addressed in only 6 studies. Several publications on process changes in surgical training programs have shown a positive effect on patient care, medical knowledge, and ABSITE scores. However, the effect on ABS certification, and other quantitative outcomes from residency programs, have not been addressed. Studies on education strategies showing evidence that residency program objectives are being achieved are still needed. This article addresses the 6 ACGME Core Competencies. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  10. What's New in 10 Years? A Revised Cardiothoracic Curriculum for Diagnostic Radiology Residency with Goals and Objectives Related to General Competencies.

    PubMed

    Nguyen, Elsie T; Ackman, Jeanne B; Rajiah, Prabhakar; Little, Brent; Wu, Carol; Bueno, Juliana M; Gilman, Mathew D; Christensen, Jared D; Madan, Rachna; Laroia, Archana T; Lee, Christopher; Kanne, Jeffrey P; Collins, Jannette

    2016-07-01

    This is a cardiothoracic curriculum document for radiology residents meant to serve not only as a study guide for radiology residents but also as a teaching and curriculum reference for radiology educators and radiology residency program directors. This document represents a revision of a cardiothoracic radiology resident curriculum that was published 10 years ago in Academic Radiology. The sections that have been significantly revised, expanded, or added are (1) lung cancer screening, (2) lung cancer genomic profiling, (3) lung adenocarcinoma revised nomenclature, (4) lung biopsy technique, (5) nonvascular thoracic magnetic resonance, (6) updates to the idiopathic interstitial pneumonias, (7) cardiac computed tomography updates, (8) cardiac magnetic resonance updates, and (9) new and emerging techniques in cardiothoracic imaging. This curriculum was written and endorsed by the Education Committee of the Society of Thoracic Radiology. This curriculum operates in conjunction with the Accreditation Council for Graduate Medical Education (ACGME) milestones project that serves as a framework for semiannual evaluation of resident physicians as they progress through their training in an ACGME-accredited residency or fellowship programs. This cardiothoracic curriculum document is meant to serve not only as a more detailed guide for radiology trainees, educators, and program directors but also complementary to and guided by the ACGME milestones. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  11. Impact of critical thinking disposition, general self-efficacy, and leadership on clinical competence in nursing students.

    PubMed

    Park, Jee Won; Kim, Chun Ja; Kim, Yong Soon; Yoo, Moon Sook; Yoo, Hyera; Chae, Sun Mi; Ahn, Jeong Ah

    2012-09-01

    The purpose of this study was to evaluate the relationships among critical thinking disposition, general self-efficacy, leadership and clinical competence, and identify the factors influencing clinical competence in nursing students. In this descriptive study, 153 nursing students (from 2nd to 4th school year) of a university in South Korea were enrolled in December 2010. The instruments for this study were the Korean versions of the Critical Thinking Disposition Scale, General Self-Efficacy Scale, Leadership Inventory, and Clinical Competence Scale. Data were analyzed by descriptive statistics, t-test, MANOVA, Pearson correlation, and multiple linear regression with PASW 18.0 software. The mean scores (ranging from 1 to 5) in nursing students for critical thinking disposition, general self-efficacy, leadership, and clinical competence were 3.44, 3.51, 3.55, and 3.42, respectively. Positive correlations were found for clinical competence with critical thinking disposition, general self-efficacy, and leadership. The strongest predictor of clinical competence was leadership. In addition, leadership, nursing school year, and subjective academic achievement accounted for 34.5% of variance in clinical competence. This study revealed that developing leadership, critical thinking disposition, and self-efficacy in undergraduate nursing education is important to improve clinical competence of nursing students.

  12. Association of the 2011 ACGME Resident Duty Hour Reforms With Mortality and Readmissions Among Hospitalized Medicare Patients

    PubMed Central

    Patel, Mitesh S.; Volpp, Kevin G.; Small, Dylan S.; Hill, Alexander S.; Even-Shoshan, Orit; Rosenbaum, Lisa; Ross, Richard N.; Bellini, Lisa; Zhu, Jingsan; Silber, Jeffrey H.

    2017-01-01

    IMPORTANCE Patient outcomes associated with the 2011 Accreditation Council for Graduate Medical Education (ACGME) duty hour reforms have not been evaluated at a national level. OBJECTIVE To evaluate the association of the 2011 ACGME duty hour reforms with mortality and readmissions. DESIGN, SETTING, AND PARTICIPANTS Observational study of Medicare patient admissions (6 384 273 admissions from 2 790 356 patients) to short-term, acute care, nonfederal hospitals (n = 3104) with principal medical diagnoses of acute myocardial infarction, stroke, gastrointestinal bleeding, or congestive heart failure or a Diagnosis Related Group classification of general, orthopedic, or vascular surgery. Of the hospitals, 96 (3.1%) were very major teaching, 138 (4.4%) major teaching, 442 (14.2%) minor teaching, 443 (14.3%) very minor teaching, and 1985 (64.0%) nonteaching. EXPOSURE Resident-to-bed ratio as a continuous measure of hospital teaching intensity. MAIN OUTCOMES AND MEASURES Change in 30-day all-location mortality and 30-day all-cause readmission, comparing patients in more intensive relative to less intensive teaching hospitals before (July 1, 2009–June 30, 2011) and after (July 1, 2011–June 30, 2012) duty hour reforms, adjusting for patient comorbidities, time trends, and hospital site. RESULTS In the 2 years before duty hour reforms, there were 4 325 854 admissions with 288 422 deaths and 602 380 readmissions. In the first year after the reforms, accounting for teaching hospital intensity, there were 2 058 419 admissions with 133 547 deaths and 272 938 readmissions. There were no significant postreform differences in mortality accounting for teaching hospital intensity for combined medical conditions (odds ratio [OR], 1.00; 95% CI, 0.96–1.03), combined surgical categories (OR, 0.99; 95% CI, 0.94–1.04), or any of the individual medical conditions or surgical categories. There were no significant postreform differences in readmissions for combined medical conditions

  13. Milestones on a Shoestring: A Cost-Effective, Semi-automated Implementation of the New ACGME Requirements for Radiology.

    PubMed

    Schmitt, J Eric; Scanlon, Mary H; Servaes, Sabah; Levin, Dayna; Cook, Tessa S

    2015-10-01

    The advent of the ACGME's Next Accreditation System represents a significant new challenge for residencies and fellowships, owing to its requirements for more complex and detailed information. We developed a system of online assessment tools to provide comprehensive coverage of the twelve ACGME Milestones and digitized them using freely available cloud-based productivity tools. These tools include a combination of point-of-care procedural assessments, electronic quizzes, online modules, and other data entry forms. Using free statistical analytic tools, we also developed an automated system for management, processing, and data reporting. After one year of use, our Milestones project has resulted in the submission of over 20,000 individual data points. The use of automated statistical methods to generate resident-specific profiles has allowed for dynamic reports of individual residents' progress. These profiles both summarize data and also allow program directors access to more granular information as needed. Informatics-driven strategies for data assessment and processing represent feasible solutions to Milestones assessment and analysis, reducing the potential administrative burden for program directors, residents, and staff. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  14. Early experience in establishing and evaluating an ACGME-approved international general surgery rotation.

    PubMed

    Tarpley, Margaret; Hansen, Erik; Tarpley, John L

    2013-01-01

    In 2011, the Accreditation Council for Graduate Medical Education Surgery Residency Review Committee first provided guidelines for elective international general surgery rotations. The Vanderbilt general surgery residency program received Surgery Residency Review Committee approval for a fourth-year elective in Kenya beginning in the 2011-2012 academic year. Because this rotation would break ground culturally and geographically, and as an educational partnership, a briefing and debriefing process was developed for this ground-breaking year. Our objectives were to prepare residents to maximize the experience without competing for cases with local trainees or overburdening the host institution and to perform continuous quality assessment and improvement as each resident returned back. Briefing included health protection strategies, a procedures manual containing step-by-step preparation activities, and cultural-sensitivity training. Institutional Review Board exemption approval was obtained to administer a questionnaire created for returning residents concerning educational value, relations with local trainees, physical environment, and personal perceptions that would provide the scaffold for the debriefing conference. The questionnaire coupled with the debriefing discussion for the first 9 participants revealed overall satisfaction with the rotation and the briefing process, good health, and no duty hours or days-off issues. Other findings include the following: (1) emotional effect of observing African families weigh cost in medical decision making; (2) satisfactory access to educational resources; (3) significant exposure to specialties such as urology and radiology; and (4) toleration of 4 weeks as a single and expressed need for leisure activity materials such as books, DVDs, or games. The responses triggered adjustments in the briefing sessions and travel preparation. The host institution invited the residents to return for the 2012-2013 year as well as 2013

  15. The State of Evaluation in Internal Medicine Residency

    PubMed Central

    Holmboe, Eric; Beasley, Brent W.

    2008-01-01

    Background There are no nationwide data on the methods residency programs are using to assess trainee competence. The Accreditation Council for Graduate Medical Education (ACGME) has recommended tools that programs can use to evaluate their trainees. It is unknown if programs are adhering to these recommendations. Objective To describe evaluation methods used by our nation’s internal medicine residency programs and assess adherence to ACGME methodological recommendations for evaluation. Design Nationwide survey. Participants All internal medicine programs registered with the Association of Program Directors of Internal Medicine (APDIM). Measurements Descriptive statistics of programs and tools used to evaluate competence; compliance with ACGME recommended evaluative methods. Results The response rate was 70%. Programs were using an average of 4.2–6.0 tools to evaluate their trainees with heavy reliance on rating forms. Direct observation and practice and data-based tools were used much less frequently. Most programs were using at least 1 of the Accreditation Council for Graduate Medical Education (ACGME)’s “most desirable” methods of evaluation for all 6 measures of trainee competence. These programs had higher support staff to resident ratios than programs using less desirable evaluative methods. Conclusions Residency programs are using a large number and variety of tools for evaluating the competence of their trainees. Most are complying with ACGME recommended methods of evaluation especially if the support staff to resident ratio is high. PMID:18612734

  16. The Media Response to the ACGME's 2017 Relaxed Resident Duty-Hour Restrictions.

    PubMed

    Zhang, Zi; Krauthamer, Alan V; Rosenkrantz, Andrew B

    2018-03-01

    In March 2017, the ACGME relaxed resident duty-hour restrictions to allow first-year residents to work 24-hour shifts, affecting the internship experience of incoming radiology residents. The aim of this study was to assess the media response to this duty-hour change, comparing news articles with favorable and unfavorable views. Google News was used to identify 36 relevant unique news articles published over a 4-week period after the announcement. Articles' stance was categorized as favorable, unfavorable, or neutral. Additional article characteristics were explored. Article sources were 58% national, 22% local, and 20% medical news. Article stance was most commonly unfavorable for national news sources (48%), compared with neutral for local (62%) and medical (72%) news sources. Most common reasons for unfavorable stance were sleep deprivation (n = 11), medical errors (n = 11), residents' health (n = 9), risk for car accidents (n = 9), a patriarchal hazing system (n = 6), and work-life balance (n = 5). Most common reasons for favorable stance were impact on resident education (n = 7) and continuity of care (n = 7). Supporting data were cited by 38% of unfavorable and 100% of favorable articles. Unfavorable articles most commonly quoted physicians affiliated with resident advocacy groups; favorable articles most commonly quoted physicians affiliated with the ACGME. The relaxed duty-hour restrictions received an overall unfavorable media response, particularly in nonmedical news sources, driven by concerns regarding sleep-deprived doctors. Favorable articles ubiquitously cited data supporting the safety of relaxed duty hour restrictions. Further research is warranted to better understand the impact of relaxed resident duty-hour limits on sleep deprivation, residents' health and education, and the quality of patient care. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  17. Evaluating Coding Accuracy in General Surgery Residents' Accreditation Council for Graduate Medical Education Procedural Case Logs.

    PubMed

    Balla, Fadi; Garwe, Tabitha; Motghare, Prasenjeet; Stamile, Tessa; Kim, Jennifer; Mahnken, Heidi; Lees, Jason

    The Accreditation Council for Graduate Medical Education (ACGME) case log captures resident operative experience based on Current Procedural Terminology (CPT) codes and is used to track operative experience during residency. With increasing emphasis on resident operative experiences, coding is more important than ever. It has been shown in other surgical specialties at similar institutions that the residents' ACGME case log may not accurately reflect their operative experience. What barriers may influence this remains unclear. As the only objective measure of resident operative experience, an accurate case log is paramount in representing one's operative experience. This study aims to determine the accuracy of procedural coding by general surgical residents at a single institution. Data were collected from 2 consecutive graduating classes of surgical residents' ACGME case logs from 2008 to 2014. A total of 5799 entries from 7 residents were collected. The CPT codes entered by residents were compared to departmental billing records submitted by the attending surgeon for each procedure. Assigned CPT codes by institutional American Academy of Professional Coders certified abstract coders were considered the "gold standard." A total of 4356 (75.12%) of 5799 entries were identified in billing records. Excel 2010 and SAS 9.3 were used for analysis. In the event of multiple codes for the same patient, any match between resident codes and billing record codes was considered a "correct" entry. A 4-question survey was distributed to all current general surgical residents at our institution for feedback on coding habits, limitations to accurate coding, and opinions on ACGME case log representation of their operative experience. All 7 residents had a low percentage of correctly entered CPT codes. The overall accuracy proportion for all residents was 52.82% (range: 43.32%-60.07%). Only 1 resident showed significant improvement in accuracy during his/her training (p = 0

  18. The state of general surgery training: a different perspective.

    PubMed

    Foley, P J; Roses, R E; Kelz, R R; Resnick, A S; Williams, N N; Mullen, J L; Kaiser, L R; Morris, Jon B

    2008-01-01

    Much has been written about the influences of Accreditation Council for Graduate Medical Education (ACGME) work restrictions, the litigious climate in American medicine, and the proliferation of subspecialty fellowships on general surgery training. Few previous studies have addressed general surgical residents' perceptions of surgical training on a national level. A 38-question Institutional Review Board-approved survey was sent via e-mail to the program directors at all ACGME-approved general surgical training programs for distribution to categorical general surgery residents. Voluntary responses to statements focusing on job satisfaction, quality of life, and the influences of operative experience, work hours, fellows, physician extenders, as well as faculty and administration on resident training were solicited. Overall, 997 responses were received from residents of all clinical levels from 40 states. Most respondents were from university-based programs (79%) with a broad representation of program sizes (mean of 6 graduates per year; range 2 to 11). Residents believe that they will be prepared to enter clinical practice at the conclusion of their training (86%), that the duration of surgical training is adequate (85%), and that they are exposed to sufficient case volume and complexity (85% and 84%, respectively). Only 360 respondents (36%) believe that they are financially compensated appropriately. Although most respondents support the ACGME work-hour restrictions (70%), far fewer feel that they improve their training or patient care (46.6% and 46.8%, respectively). Most respondents are proud to be surgical residents (88%), view surgery as a rewarding profession (87%), and would choose surgery as a profession again (77%). Surgical residents are positive regarding the quality of their training and life, although they feel poorly compensated for their work. Most residents intend to pursue fellowship training. Survey responses were consistent irrespective of

  19. General surgery education across three continents.

    PubMed

    McIlhenny, Craig; Kurashima, Yo; Chan, Carlos; Hirano, Satoshi; Domínguez-Rosado, Ismael; Stefanidis, Dimitrios

    2018-02-01

    Surgical education has seen tremendous changes in the US over the past decade. The Halstedian training model of see one, do one, teach one that governed surgical training for almost 100 years has been replaced by the achievement of the ACGME competencies, milestones, entrustable professional activities (EPAs), and acquisition of surgical skill outside the operating room on simulators. Several of these changes in American medical education have been influenced by educators and training paradigms abroad. In this paper, we review the training paradigms for surgeons in the UK, Japan, and Mexico to allow comparisons with the US training paradigm and promote the exchange of ideas. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Required and Elective Experiences During the 4th Year: An Analysis of ACGME Accredited Psychiatry Residency Program Websites.

    PubMed

    Vestal, Heather S; Belitsky, Richard; Bernstein, Carol A; Chaukos, Deanna; Cohen, Mitchell B; Dickstein, Leah J; Hilty, Donald M; Hutner, Lucy; Sakman, Ferda; Scheiber, Stephen C; Wrzosek, Marika I; Silberman, Edward K

    2016-10-01

    The objective of this study was to assess and describe required and elective components of the 4th post-graduate year (PGY4) in psychiatry residency programs. We reviewed the websites of all 193 2014-2015 ACGME accredited psychiatry residency programs for content describing the specific components of the PGY4 year. Nearly all residency programs (99 %) had some form of required experiences during the PGY4 year. Ninety-four percent had clinical requirements for PGY4 residents, with longitudinal outpatient clinic being the most common (77 %). All programs offered some elective time during PGY4, but the amount of time ranged from 2 months to 100 %. Virtually all residency programs include some requirements in the 4th year (most commonly didactics and outpatient clinic) in addition to a broad array of elective experiences. Although 3 years may suffice for residents to complete ACGME requirements, a variety of factors may motivate programs to include required 4th year curricula. Future studies should explore the rationales for and possible benefits of programmatic requirements throughout 4 versus only 3 years of psychiatric training.

  1. Resident dashboards: helping your clinical competency committee visualize trainees' key performance indicators.

    PubMed

    Friedman, Karen A; Raimo, John; Spielmann, Kelly; Chaudhry, Saima

    2016-01-01

    Under the Next Accreditation System, programs need to find ways to collect and assess meaningful reportable information on its residents to assist the program director regarding resident milestone progression. This paper discusses the process that one large Internal Medicine Residency Program used to provide both quantitative and qualitative data to its clinical competency committee (CCC) through the creation of a resident dashboard. Program leadership at a large university-based program developed four new end of rotation evaluations based on the American Board of Internal Medicine (ABIM) and Accreditation Council of Graduated Medical Education's (ACGME) 22 reportable milestones. A resident dashboard was then created to pull together both milestone- and non-milestone-based quantitative data and qualitative data compiled from faculty, nurses, peers, staff, and patients. Dashboards were distributed to the members of the CCC in preparation for the semiannual CCC meeting. CCC members adjudicated quantitative and qualitative data to present their cohort of residents at the CCC meeting. Based on the committee's response, evaluation scores remained the same or were adjusted. Final milestone scores were then entered into the accreditation data system (ADS) on the ACGME website. The process of resident assessment is complex and should comprise both quantitative and qualitative data. The dashboard is a valuable tool for program leadership to use both when evaluating house staff on a semiannual basis at the CCC and to the resident in person.

  2. Welcome to cultural competency: surgery's efforts to acknowledge diversity in residency training.

    PubMed

    Ly, Catherine L; Chun, Maria B J

    2013-01-01

    Although cultural competency is not a new concept in healthcare, it has only recently been formally embraced as important in the field of surgery. All physicians, including and especially surgeons, must acknowledge the potential influence of culture in order to provide effective and equitable care for patients of all backgrounds. The Accreditation Council for Graduate Medical Education (ACGME) recognizes cultural competency as a component of "patient care," "professionalism," and "interpersonal and communication skills." A systematic literature search was conducted using the MEDLINE, EBSCOhost, Web of Science, and Google Scholar databases. All publications focusing on surgical residents and the assessment of patient care, professionalism, interpersonal and communication skills, or specifically cultural competency and/or were considered. This initial search resulted in 12 articles. To further refine the review, publications discussing curricula in residencies other than surgery, the assessment of technical, or clinical skills and/or without any explicit focus on cultural competency were excluded. Based on the specified inclusion and exclusion criteria, 5 articles were selected. These studies utilized various methods to improve surgical residents' cultural competency, including lectures, Objective Structural Clinical Examinations (OSCE), and written exercises and evaluations. A number of surgical residency programs have made promising strides in training culturally competent surgeons. Ultimately, in order to maximize our collective efforts to improve the quality of health care, the development of cultural competency curricula must be made a priority and such training should be a requirement for all trainees in surgical residency programs. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  3. General Mechanical Repair. Minor Automotive Maintenance, Small Engine [Repair, and] Welding: Competency Test Package.

    ERIC Educational Resources Information Center

    Hamlin, Larry

    This document contains the competency test package for three sections of a general mechanical repair course: minor automotive maintenance, small engine mechanics, and welding. Following a list of the common essential elements for trade and industrial education, competency tests for the three sections are provided. Each test includes unit name,…

  4. Milestones: a rapid assessment method for the Clinical Competency Committee

    PubMed Central

    Nabors, Christopher; Forman, Leanne; Peterson, Stephen J.; Gennarelli, Melissa; Aronow, Wilbert S.; DeLorenzo, Lawrence; Chandy, Dipak; Ahn, Chul; Sule, Sachin; Stallings, Gary W.; Khera, Sahil; Palaniswamy, Chandrasekar; Frishman, William H.

    2016-01-01

    Introduction Educational milestones are now used to assess the developmental progress of all U.S. graduate medical residents during training. Twice annually, each program’s Clinical Competency Committee (CCC) makes these determinations and reports its findings to the Accreditation Council for Graduate Medical Education (ACGME). The ideal way to conduct the CCC is not known. After finding that deliberations reliant upon the new milestones were time intensive, our internal medicine residency program tested an approach designed to produce rapid but accurate assessments. Material and methods For this study, we modified our usual CCC process to include pre-meeting faculty ratings of resident milestones progress with in-meeting reconciliation of their ratings. Data were considered largely via standard report and presented in a pre-arranged pattern. Participants were surveyed regarding their perceptions of data management strategies and use of milestones. Reliability of competence assessments was estimated by comparing pre-/post-intervention class rank lists produced by individual committee members with a master class rank list produced by the collective CCC after full deliberation. Results Use of the study CCC approach reduced committee deliberation time from 25 min to 9 min per resident (p < 0.001). Committee members believed milestones improved their ability to identify and assess expected elements of competency development (p = 0.026). Individual committee member assessments of trainee progress agreed well with collective CCC assessments. Conclusions Modification of the clinical competency process to include pre-meeting competence ratings with in-meeting reconciliation of these ratings led to shorter deliberation times, improved evaluator satisfaction and resulted in reliable milestone assessments. PMID:28144272

  5. Individualised training to improve teaching competence of general practitioner trainers: a randomised controlled trial.

    PubMed

    Schol, Sandrina; Goedhuys, Jo; Notten, Ton; Betz, Wim

    2005-10-01

    In Flanders an important part of training to become a general practitioner (GP) is undertaken within a general practice. This requires a GP trainer to know how to facilitate learning processes. This paper reports a study focused on the research question: Does short but individualised training of GP trainers contribute to their teaching competence? A total of 47 GP trainers were randomly divided into 2 groups of a pretest/post-test control group design. After a multiple-station teaching assessment test (MSTAT), the experimental group received a short but individualised training to improve teaching competence while the control group were given no specific programme regarding teaching competence. One year later, all participants were invited to sit the post-test. In all, 61 GP trainers participated in the pretest and 51 in the post-test; 44 GP trainers participated in both tests. Despite the large attrition, the internal validity of the experiment was preserved. Beginners gained a median score of 2.04 (on a scale of 0-5) on the first MSTAT. In the post-test, the experimental group (median = 3.12) scored significantly better on the entire test (Mann-Whitney U = 166.5, P < 0.05) compared with the control group (median = 2.84). However, the GP trainers in the control group also appeared to have made progress. General practitioners who start as GP trainers have insufficient teaching competence to guarantee good coaching of students. A personal programme leads to progress in teaching competence; however, it would seem that more time and support are necessary to allow GP trainers to gain full teaching competence. The fact that the control group made progress as well suggests that the test had an important learning effect.

  6. Does operative experience during residency correlate with reported competency of recent general surgery graduates?

    PubMed Central

    Safavi, Arash; Lai, Sarah; Butterworth, Sonia; Hameed, Morad; Schiller, Dan; Skarsgard, Erik

    2012-01-01

    Background Identification of attributes of residency training that predict competency would improve surgical education. We hypothesized that case experience during residency would correlate with self-reported competency of recent graduates. Methods Aggregate case log data of residents enrolled in 2 general surgery programs were collected over a 12-month period and stratified into Surgical Council on Resident Education (SCORE) categories. We surveyed recent (< 5 yr) residency graduates on procedural competency. Resident case volumes were correlated with survey responses by SCORE category. Results In all, 75 residents performed 11 715 operations, which were distributed by SCORE category as follows: essential-common (EC) 9935 (84.8%), essential-uncommon (EU) 889 (7.6%) and complex 891 (7.6%). Alimentary tract procedures were the most commonly performed EC (2386, 24%) and EU (504, 56.7%) procedures. The least common EC procedure was plastic surgery (4, 0.04%), and the least common EU procedure was abdomen–spleen (1, 0.1%). The questionnaire response rate was 45%. For EC procedures, self-reported competency was highest in skin and soft tissue, thoracic and head and neck (each 100%) and lowest in vascular–venous (54%), whereas for EU procedures it was highest in abdomen–general (100%) and lowest in vascular–arterial (62%). The correlation between case volume and self-reported competency was poor (R = 0.2 for EC procedures). Conclusion Self-reported competency correlates poorly with operative case experience during residency. Other curriculum factors, including specific rotations and timing, balance between inpatient and outpatient surgical experience and competition for cases, may contribute to procedural competency acquisition during residency. PMID:22854144

  7. Providing competency-based family medicine residency training in substance abuse in the new millennium: a model curriculum.

    PubMed

    Seale, J Paul; Shellenberger, Sylvia; Clark, Denice Crowe

    2010-05-11

    This article, developed for the Betty Ford Institute Consensus Conference on Graduate Medical Education (December, 2008), presents a model curriculum for Family Medicine residency training in substance abuse. The authors reviewed reports of past Family Medicine curriculum development efforts, previously-identified barriers to education in high risk substance use, approaches to overcoming these barriers, and current training guidelines of the Accreditation Council for Graduate Medical Education (ACGME) and their Family Medicine Residency Review Committee. A proposed eight-module curriculum was developed, based on substance abuse competencies defined by Project MAINSTREAM and linked to core competencies defined by the ACGME. The curriculum provides basic training in high risk substance use to all residents, while also addressing current training challenges presented by U.S. work hour regulations, increasing international diversity of Family Medicine resident trainees, and emerging new primary care practice models. This paper offers a core curriculum, focused on screening, brief intervention and referral to treatment, which can be adapted by residency programs to meet their individual needs. The curriculum encourages direct observation of residents to ensure that core skills are learned and trains residents with several "new skills" that will expand the basket of substance abuse services they will be equipped to provide as they enter practice. Broad-based implementation of a comprehensive Family Medicine residency curriculum should increase the ability of family physicians to provide basic substance abuse services in a primary care context. Such efforts should be coupled with faculty development initiatives which ensure that sufficient trained faculty are available to teach these concepts and with efforts by major Family Medicine organizations to implement and enforce residency requirements for substance abuse training.

  8. Resident dashboards: helping your clinical competency committee visualize trainees' key performance indicators.

    PubMed

    Friedman, Karen A; Raimo, John; Spielmann, Kelly; Chaudhry, Saima

    2016-01-01

    Introduction Under the Next Accreditation System, programs need to find ways to collect and assess meaningful reportable information on its residents to assist the program director regarding resident milestone progression. This paper discusses the process that one large Internal Medicine Residency Program used to provide both quantitative and qualitative data to its clinical competency committee (CCC) through the creation of a resident dashboard. Methods Program leadership at a large university-based program developed four new end of rotation evaluations based on the American Board of Internal Medicine (ABIM) and Accreditation Council of Graduated Medical Education's (ACGME) 22 reportable milestones. A resident dashboard was then created to pull together both milestone- and non-milestone-based quantitative data and qualitative data compiled from faculty, nurses, peers, staff, and patients. Results Dashboards were distributed to the members of the CCC in preparation for the semiannual CCC meeting. CCC members adjudicated quantitative and qualitative data to present their cohort of residents at the CCC meeting. Based on the committee's response, evaluation scores remained the same or were adjusted. Final milestone scores were then entered into the accreditation data system (ADS) on the ACGME website. Conclusions The process of resident assessment is complex and should comprise both quantitative and qualitative data. The dashboard is a valuable tool for program leadership to use both when evaluating house staff on a semiannual basis at the CCC and to the resident in person.

  9. Two Novel Approaches to Improve Otolaryngology Resident Wellness: The ACGME Back to Bedside Initiative.

    PubMed

    Ambrose, Emily C; Devare, Jenna; Truesdale, Carl M; Ricker, Ellen; Firn, Janice; Thorne, Marc C; Shuman, Andrew G; Cabrera-Muffly, Cristina

    2018-06-01

    Rates of burnout, mental illness, and suicide are disproportionately elevated among physicians, and surgical specialists, including otolaryngologists, are at even higher risk for professional burnout. These trends have been identified at both the trainee and attending level. To combat resident burnout, the Accreditation Council for Graduate Medical Education (ACGME) Council of Review Committee Residents (CRCR) designed the Back to Bedside Initiative, the goals of which are to foster meaning in the learning environment and to help trainees to engage more deeply with patients. Two funded Back to Bedside proposals involve otolaryngology training programs. Herein, we discuss these 2 approaches in an effort to foster additional novel resident wellness initiatives and awareness thereof across our subspecialty.

  10. Validated Competency Task Lists for General Merchandise Retailing, Food Service Management, and Business and Personal Services Marketing.

    ERIC Educational Resources Information Center

    Faught, Suzanne G.

    This publication contains competency task lists that address principal entry-level and career-sustaining jobs in the occupational categories of general merchandise retailing, food service management, and business and personal services marketing. Section I, Development of the Competency Task Lists, provides details on how the competencies were…

  11. Individualized education and competency development of Croatian community pharmacists using the general level framework.

    PubMed

    Meštrović, Arijana; Staničić, Zivka; Hadžiabdić, Maja Ortner; Mucalo, Iva; Bates, Ian; Duggan, Catherine; Carter, Sarah; Bruno, Andreia; Košiček, Miljenko

    2012-03-12

    To measure Croatian community pharmacists' progress in competency development using the General Level Framework (GLF) as an educational tool in a longitudinal study. Patient care competencies of 100 community pharmacists were evaluated twice, in 2009 and in 2010 in a prospective cohort study. During this 12-month period, tailored educational programs based on the GLF were organized and conducted, new services and standard operating procedures were implemented, and documentation of contributions to patient care in the pharmacist's portfolio became mandatory. Pharmacists' development of all GLF patient care competencies was significant with the greatest improvements seen in the following competencies: patient consultation, monitoring drug therapy, medicine information and patient education, and evaluation of outcomes. This study, which retested the effectiveness of an evidence-based competency framework, confirmed that GLF is a valid educational tool for pharmacist development.

  12. Are Generalized Anxiety and Depression Symptoms Associated with Social Competence in Children with and without Autism Spectrum Disorder?

    PubMed

    Johnston, Krista Haley Smith; Iarocci, Grace

    2017-12-01

    Generalized anxiety and depression symptoms may be associated with poorer social outcomes among children with Autism Spectrum Disorder (ASD) without intellectual disability. The goal of this study was to examine whether generalized anxiety and depression symptoms were associated with social competence after accounting for IQ, age, and gender in typically developing children and in children with ASD. Results indicated that for the TD group, generalized anxiety and depression accounted for 38% of the variance in social competence and for children with ASD, they accounted for 29% of the variance in social competence. However, only depression accounted for a significant amount of the variance. The findings underscore the importance of assessing the social impact of internalizing symptoms in children with ASD.

  13. Predicting first-grade mathematics achievement: the contributions of domain-general cognitive abilities, nonverbal number sense, and early number competence.

    PubMed

    Hornung, Caroline; Schiltz, Christine; Brunner, Martin; Martin, Romain

    2014-01-01

    Early number competence, grounded in number-specific and domain-general cognitive abilities, is theorized to lay the foundation for later math achievement. Few longitudinal studies have tested a comprehensive model for early math development. Using structural equation modeling and mediation analyses, the present work examined the influence of kindergarteners' nonverbal number sense and domain-general abilities (i.e., working memory, fluid intelligence, and receptive vocabulary) and their early number competence (i.e., symbolic number skills) on first grade math achievement (i.e., arithmetic, shape and space skills, and number line estimation) assessed 1 year later. Latent regression models revealed that nonverbal number sense and working memory are central building blocks for developing early number competence in kindergarten and that early number competence is key for first grade math achievement. After controlling for early number competence, fluid intelligence significantly predicted arithmetic and number line estimation while receptive vocabulary significantly predicted shape and space skills. In sum we suggest that early math achievement draws on different constellations of number-specific and domain-general mechanisms.

  14. Predicting first-grade mathematics achievement: the contributions of domain-general cognitive abilities, nonverbal number sense, and early number competence

    PubMed Central

    Hornung, Caroline; Schiltz, Christine; Brunner, Martin; Martin, Romain

    2014-01-01

    Early number competence, grounded in number-specific and domain-general cognitive abilities, is theorized to lay the foundation for later math achievement. Few longitudinal studies have tested a comprehensive model for early math development. Using structural equation modeling and mediation analyses, the present work examined the influence of kindergarteners' nonverbal number sense and domain-general abilities (i.e., working memory, fluid intelligence, and receptive vocabulary) and their early number competence (i.e., symbolic number skills) on first grade math achievement (i.e., arithmetic, shape and space skills, and number line estimation) assessed 1 year later. Latent regression models revealed that nonverbal number sense and working memory are central building blocks for developing early number competence in kindergarten and that early number competence is key for first grade math achievement. After controlling for early number competence, fluid intelligence significantly predicted arithmetic and number line estimation while receptive vocabulary significantly predicted shape and space skills. In sum we suggest that early math achievement draws on different constellations of number-specific and domain-general mechanisms. PMID:24772098

  15. A real-world approach to Evidence-Based Medicine in general practice: a competency framework derived from a systematic review and Delphi process.

    PubMed

    Galbraith, Kevin; Ward, Alison; Heneghan, Carl

    2017-05-03

    Evidence-Based Medicine (EBM) skills have been included in general practice curricula and competency frameworks. However, GPs experience numerous barriers to developing and maintaining EBM skills, and some GPs feel the EBM movement misunderstands, and threatens their traditional role. We therefore need a new approach that acknowledges the constraints encountered in real-world general practice. The aim of this study was to synthesise from empirical research a real-world EBM competency framework for general practice, which could be applied in training, in the individual pursuit of continuing professional development, and in routine care. We sought to integrate evidence from the literature with evidence derived from the opinions of experts in the fields of general practice and EBM. We synthesised two sets of themes describing the meaning of EBM in general practice. One set of themes was derived from a mixed-methods systematic review of the literature; the other set was derived from the further development of those themes using a Delphi process among a panel of EBM and general practice experts. From these two sets of themes we constructed a real-world EBM competency framework for general practice. A simple competency framework was constructed, that acknowledges the constraints of real-world general practice: (1) mindfulness - in one's approach towards EBM itself, and to the influences on decision-making; (2) pragmatism - in one's approach to finding and evaluating evidence; and (3) knowledge of the patient - as the most useful resource in effective communication of evidence. We present a clinical scenario to illustrate how a GP might demonstrate these competencies in their routine daily work. We have proposed a real-world EBM competency framework for general practice, derived from empirical research, which acknowledges the constraints encountered in modern general practice. Further validation of these competencies is required, both as an educational resource and as a

  16. Increased Mortality Rates During Resident Handoff Periods and the Effect of ACGME Duty Hour Regulations.

    PubMed

    Denson, Joshua L; McCarty, Matthew; Fang, Yixin; Uppal, Amit; Evans, Laura

    2015-09-01

    Medical errors occur following handoff-related miscommunication. Data regarding the effect on patient-centered outcomes, specifically mortality, are lacking. Our objective was to investigate handoff-related mortality and the effect of duty-hour regulations. Retrospective cohort study of adult medical patients at a public, university-affiliated hospital from 2010 to 2012. Patients were divided into 2 cohorts: handoff group (discharged within 7 days following a change in resident physician team) vs control group (discharged the 3 weeks of each 4-week rotation before resident service change). The primary outcome was unadjusted and adjusted hospital mortality rate. As a secondary prespecified analysis, we examined the effect of 2011 Accreditation Council for Graduate Medical Education (ACGME) duty-hour changes. Among 23,736 patients, unadjusted hospital mortality during the handoff group was higher than the control group (2.68% vs 2.08%, respectively; P = .007; odds ratio [OR] 1.30; 95% confidence interval [CI], 1.08-1.57). Following adjustment, this association remained statistically significant (adjusted OR 1.34; P = .003; 95% CI, 1.10-1.62). Similarly, pre-duty-hour unadjusted hospital mortality was higher in the handoff group vs control group (2.87% vs 2.01%, respectively; P = .006; OR 1.44; 95% CI, 1.11-1.86), which remained statistically significant following adjustment (adjusted OR 1.50; P = .002; 95% CI, 1.16-1.95). However, this association lost statistical significance following duty-hour revision with respect to both unadjusted (2.48% vs 2.15%, respectively; P = .30; OR 1.16; 95% CI, 0.88-1.53) and adjusted mortality (OR 1.18; P = .26; 95% CI, 0.89-1.56). Resident transition in care was significantly associated with an increase in unadjusted and adjusted hospital mortality. Although improved by 2011 ACGME duty-hour amendments, a trend toward higher mortality remained following resident handoff. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Navigating the pathway to robotic competency in general thoracic surgery.

    PubMed

    Seder, Christopher W; Cassivi, Stephen D; Wigle, Dennis A

    2013-01-01

    Although robotic technology has addressed many of the limitations of traditional videoscopic surgery, robotic surgery has not gained widespread acceptance in the general thoracic community. We report our initial robotic surgery experience and propose a structured, competency-based pathway for the development of robotic skills. Between December 2008 and February 2012, a total of 79 robot-assisted pulmonary, mediastinal, benign esophageal, or diaphragmatic procedures were performed. Data on patient characteristics and perioperative outcomes were retrospectively collected and analyzed. During the study period, one surgeon and three residents participated in a triphasic, competency-based pathway designed to teach robotic skills. The pathway consisted of individual preclinical learning followed by mentored preclinical exercises and progressive clinical responsibility. The robot-assisted procedures performed included lung resection (n = 38), mediastinal mass resection (n = 19), hiatal or paraesophageal hernia repair (n = 12), and Heller myotomy (n = 7), among others (n = 3). There were no perioperative mortalities, with a 20% complication rate and a 3% readmission rate. Conversion to a thoracoscopic or open approach was required in eight pulmonary resections to facilitate dissection (six) or to control hemorrhage (two). Fewer major perioperative complications were observed in the later half of the experience. All residents who participated in the thoracic surgery robotic pathway perform robot-assisted procedures as part of their clinical practice. Robot-assisted thoracic surgery can be safely learned when skill acquisition is guided by a structured, competency-based pathway.

  18. A systems approach for implementing practice-based learning and improvement and systems-based practice in graduate medical education.

    PubMed

    Varkey, Prathibha; Karlapudi, Sudhakar; Rose, Steven; Nelson, Roger; Warner, Mark

    2009-03-01

    The Accreditation Council for Graduate Medical Education (ACGME) initiated its Outcome Project to better prepare physicians-in-training to practice in the rapidly changing medical environment and mandated assessment of competency in six outcomes, including Practice-Based Learning and Improvement (PBLI) and Systems-Based Practice (SBP). Before the initiation of the Outcome Project, these competencies were not an explicit element of most graduate medical education training programs. Since 1999, directors of ACGME-accredited programs nationwide have been challenged to teach and assess these competencies. The authors describe an institution-wide curriculum intended to facilitate the teaching and assessment of PBLI and SBP competencies in the 115 ACGME-accredited residency and fellowship programs (serving 1,327 trainees) sponsored by Mayo School of Graduate Medical Education. Strategies to establish the curriculum in 2005 included development of a Quality Improvement (QI) curriculum Web site, one-on-one consultations with program directors, a three-hour program director workshop, and didactic sessions for residents and fellows on core topics. An interim program director self-assessment survey revealed a 13% increase in perceived ability to measure competency in SBP, no change in their perceived ability to measure competence in PBLI, a 15% increase in their ability to provide written documentation of competence in PBLI, and a 35% increase in their ability to provide written documentation of competence in SBP between 2005 and 2007. Nearly 70% of the programs had trainees participating in QI projects. Further research is needed to evaluate the cost-effectiveness of such a program and to measure its impact on learner knowledge, skills, and attitudes and, ultimately, on patient outcomes.

  19. HIPAA Compliance with Mobile Devices Among ACGME Programs.

    PubMed

    McKnight, Randall; Franko, Orrin

    2016-05-01

    To analyze self-reported HIPAA compliance with mobile technologies among residents, fellows, and attendings at ACGME training programs. A digital survey was sent to 678 academic institutions over a 1-month period. 2427 responses were analyzed using Chi-squared tests for independence. Post-hoc Bonferroni correction was applied for all comparisons between training levels, clinical setting, and specialty. 58 % of all residents self-report violating HIPAA by sharing protected health information (PHI) via text messaging with 27 % reporting they do it "often" or "routinely" compared to 15-19 % of attendings. For all specialties, 35 % of residents use text messaging photo or video sharing with PHI. Overall, 5 % of respondents "often" or "routinely" used HIPAA compliant (HCApps) with no significant differences related to training level. 20 % of residents admitted to using non-encrypted email at some point. 53 % of attendings and 41 % of residents utilized encrypted email routinely. Physicians from surgical specialties compared to non-surgical specialties demonstrated higher rates of HIPAA violations with SMS use (35 % vs. 17.7 %), standard photo/video messages (16.3 % vs. 4.7 %), HCApps (10.9 % vs. 4.9 %), and non-HCApps (5.6 % vs 1.5 %). The most significant barriers to complying with HIPAA were inconvenience (58 %), lack of knowledge (37 %), unfamiliarity (34 %), inaccessible (29 %) and habit (24 %). Medical professionals must acknowledge that despite laws to protect patient confidentiality in the era of mobile technology, over 50 % of current medical trainees knowingly violate these rules regularly despite the threat of severe consequences. The medical community must further examine the reason for these inconsistencies and work towards possible solutions.

  20. The Relationship Between ACGME Duty Hour Requirements and Performance on the American Board of Emergency Medicine Qualifying Examination.

    PubMed

    Counselman, Francis L; Kowalenko, Terry; Marco, Catherine A; Joldersma, Kevin B; Korte, Robert C; Reisdorff, Earl J

    2016-10-01

    In 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted requirements that limited the number of hours residents could spend on duty, and in 2011, it revised these requirements. This study explored whether the implementation of the 2003 and 2011 duty hour limits was associated with a change in emergency medicine residents' performance on the American Board of Emergency Medicine (ABEM) Qualifying Examination (QE). Beginning with the 1999 QE and ending with the 2014 QE, candidates for whom all training occurred without duty hour requirements (Group A), candidates under the first set of duty hour requirements (Group C), and candidates under the second set of duty hour requirements (Group E) were compared. Comparisons included mean scores and pass rates. In Group A, 5690 candidates completed the examination, with a mean score of 82.8 and a 90.2% pass rate. In Group C, 8333 candidates had a mean score of 82.4 and a 90.5% pass rate. In Group E, there were 1269 candidates, with a mean score of 82.5 and an 89.4% pass rate. There was a small but statistically significant decrease in the mean scores (0.04, P  < .001) after implementation of the first duty hour requirements, but this difference did not occur after implementation of the 2011 standards. There was no difference among pass rates for any of the study groups (χ 2  = 1.68, P  = .43). We did not identify an association between the 2003 and 2011 ACGME duty hour requirements and performance of test takers on the ABEM QE.

  1. Gaps in exposure to essential competencies in hand surgery fellowship training: a national survey of program directors.

    PubMed

    Sears, Erika Davis; Larson, Bradley P; Chung, Kevin C

    2013-03-01

    Graduate medical education has moved towards competency-based training. The aim of this study was to assess hand surgery program directors' opinions of exposure gaps in core competencies rated as essential for hand surgery training. We surveyed the 74 ACGME hand surgery fellowship program directors. Respondents rated their opinion of 9 general areas of practice, 97 knowledge topics, and 172 procedures into one of three categories: essential, exposure needed, or unnecessary. Program directors also rated trainee exposure of each component at their respective program. Moderate and large exposure gaps were respectively defined as presence of at least 25 and 50 % of programs rating trainees as not having proficiency in the component at the end of training. Sixty-two of 74 program directors (84 %) responded to the survey. For the 76 knowledge topics and 98 procedures rated as essential, a majority of the knowledge topics (61 %; n = 46) and procedures (72 %; n = 71) had at least a moderate exposure gap. In addition, 22 % (n = 17) of the essential knowledge topics and 26 % (n = 25) of the essential procedures had a large exposure gap. This study illuminates the discrepancies between what is believed to be important for practicing hand surgeons and graduates' proficiency as perceived by program directors. The field of hand surgery must work to determine if program directors have unrealistic expectations for what is essential for practicing hand surgeons or if reforms are needed to improve exposure to essential skills in hand surgery training.

  2. General practice, primary care, and health service psychology: concepts, competencies, and the Combined-Integrated model.

    PubMed

    Schulte, Timothy J; Isley, Elayne; Link, Nancy; Shealy, Craig N; Winfrey, LaPearl Logan

    2004-10-01

    The profession of psychology is being impacted profoundly by broader changes within the national system of health care, as mental and behavioral health services are being recognized as essential components of a comprehensive, preventive, and cost-efficient primary care system. To fully define and embrace this role, the discipline of professional psychology must develop a shared disciplinary identity of health service psychology and a generalized competency-based model for doctoral education and training. This very framework has been adopted by Combined-Integrated (C-I) doctoral programs in professional psychology, which train across the practice areas (clinical, counseling, and school psychology) to provide a general and integrative foundation for their students. Because C-I programs produce general practitioners who are competent to function within a variety of health service settings, this innovative training approach has great potential to educate and train psychologists for a changing health care marketplace. Copyright 2004 Wiley Periodicals, Inc.

  3. Incorporating cultural competency into the general surgery residency curriculum: a preliminary assessment.

    PubMed

    Chun, Maria B J; Young, Keane G M; Jackson, David S

    2009-08-01

    In response to the growing diversity of the United States population and concerns with health disparities, formal training in cross-cultural care has become mandatory for all medical specialties, including surgery. The aim of this study was to assess the readiness of a general surgery residency program to incorporate cultural competency initiatives into its curriculum. Eighteen surgical teaching faculty (at a community-based hospital with a university affiliation) voluntarily participated in a qualitative study to share their views on cultural competency and to discuss ways that it could potentially be incorporated into the curriculum. Reflective of current definitions of cultural competency, faculty viewed the term culture broadly (i.e., beyond race and ethnicity). Suggested instructional methods varied, with some noting that exposure to different cultures was helpful. Others stated the importance of faculty serving as role models. Most faculty in this study appear open to cultural training, but desire a clear understanding of what that would entail and how it can be taught. They also acknowledged the lack of time to address cultural issues. Taking into consideration these and other concerns, planned curricular interventions are also presented.

  4. General Practitioners' Attitudes towards Essential Competencies in End-of-Life Care: A Cross-Sectional Survey.

    PubMed

    Giezendanner, Stéphanie; Jung, Corinna; Banderet, Hans-Ruedi; Otte, Ina Carola; Gudat, Heike; Haller, Dagmar M; Elger, Bernice S; Zemp, Elisabeth; Bally, Klaus

    2017-01-01

    Identifying essential competencies in end-of-life care, as well as general practitioners' (GPs) confidence in these competencies, is essential to guide training and quality improvement efforts in this domain. To determine which competencies in end-of-life care are considered important by GPs, to assess GPs' confidence in these competencies in a European context and their reasons to refer terminally ill patients to a specialist. Cross-sectional postal survey involving a stratified random sample of 2000 GPs in Switzerland in 2014. Survey development was informed by a previous qualitative exploration of relevant end-of-life GP competencies. Main outcome measures were GPs' assessment of the importance of and confidence in 18 attributes of end-of-life care competencies, and reasons for transferring care of terminally-ill patients to a specialist. GP characteristics associated with main outcome measures were tested using multivariate regression models. The response rate was 31%. Ninety-nine percent of GPs considered the recognition and treatment of pain as important, 86% felt confident about it. Few GPs felt confident in cultural (16%), spiritual (38%) and legal end-of-life competencies such as responding to patients seeking assisted suicide (35%) although more than half of the respondents regarded these competencies as important. Most frequent reasons to refer terminally ill patients to a specialist were lack of time (30%), better training of specialists (23%) and end-of-life care being incompatible with other duties (19%). In multiple regression analyses, confidence in end-of-life care was positively associated with GPs' age, practice size, home visits and palliative training. GPs considered non-somatic competencies (such as spiritual, cultural, ethical and legal aspects) nearly as important as pain and symptom control. Yet, few GPs felt confident in these non-somatic competencies. These findings should inform training and quality improvement efforts in this domain, in

  5. Perceptions of Leaders and Clinician Educators on the Impact of International Accreditation.

    PubMed

    Archuleta, Sophia; Ibrahim, Halah; Stadler, Dora J; Shah, Nina G; Chew, Nicholas W; Cofrancesco, Joseph

    2015-11-01

    Graduate medical education (GME) is responding to calls for reform by adopting competency-based frameworks and, in some countries, by rapidly implementing external accreditation systems. The Accreditation Council for Graduate Medical Education International (ACGME-I) began accrediting institutions in 2009. This study aimed to describe ACGME-I-accredited institutions and explore perceptions of their leaders and clinician educators (CEs) regarding preparedness, challenges, and initial impact of accreditation. Cross-sectional surveys of all ACGME-I-accredited institutions' leaders and CEs were conducted from June 2013 to June 2014. Eligible participants were identified through institution Web sites and GME offices. Combinations of Web- and paper-based surveys were employed. Completed surveys were received from 24 (70.6%) of 34 institutional leaders and 274 (76.3%) of 359 CEs, representing 3 countries, 8 academic medical centers, 2 affiliated teaching hospitals, and 47 residency programs. Leaders and CEs felt prepared in the domains of knowledge and implementation of the competencies. Top challenges were excessive "demands on faculty time" and "bureaucratic procedures." The majority of both groups perceived a positive impact of accreditation on all learner, faculty, institution, and patient outcomes; most perceived no impact on patient satisfaction. Overall, 79.2% of leaders and 75.8% of CEs agreed or strongly agreed that seeking ACGME-I accreditation was worthwhile. This study indicates that despite the challenges identified, initial perceptions of the impact of ACGME-I accreditation are positive. Findings from this study may be useful to institutions and countries considering similar GME reform, though long-term outcome data are needed.

  6. Restriction of ACGME fellowships to candidates completing US and Canadian accredited residencies: level of support and expected consequences.

    PubMed

    Orru', Emanuele; Arenson, Ronald A; Schaefer, Pamela W; Mukherji, Suresh K; Yousem, David M

    2014-08-01

    The aim of this study was to determine the level of support for the proposal to restrict ACGME-accredited fellowships to candidates who completed residencies accredited by the ACGME or the Royal College of Physicians and Surgeons of Canada. Perceptions of foreign-trained international medical graduates during and after fellowships were also assessed. An e-mail survey was sent to the members of the organizations that represent academic chairpersons (the Society of Chairs of Academic Radiology Departments) and radiology residency and fellowship program directors (the Association of Program Directors in Radiology) and to the program directors of the largest American radiology subspecialty society (the American Society of Neuroradiology). Results were analyzed separately for each of the 3 societies interviewed and then as a composite report for all 3 societies. Approximately 60% of the respondents said that they have offered at least one fellowship or faculty position to foreign-trained applicants in the past 5 years. More than 70% of the respondents said that these doctors performed equally to or better than American-trained ones both clinically and academically. The majority of members of all 3 societies responding opposed enactment of the rule, with the American Society of Neuroradiology being the most disapproving. The main concerns of those supporting the new rule were the inhomogeneous and sometimes unknown levels of training of the foreign-trained doctors and the need to favor American graduates. Those opposed were mostly worried about diminishing the quality of fellowship candidates, programs being unable to fill their positions, and a decrease in academic-oriented people. Most respondents opposed the proposed rule. The majority were supportive of foreign-trained physicians continuing their training in the United States. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  7. [Attrition and poor performance in general practice training: age, competence and knowledge play a role].

    PubMed

    Vermeulen, Margit I; Kuyvenhoven, Marijke M; Zuithoff, N P A Peter; van der Graaf, Yolanda; Pieters, H M Ron

    2011-01-01

    To investigate which determinants are related to poor performance and forced attrition in the first year residency in general practice (GP). Observational retrospective cohort study. We collected data relating to personal characteristics such as age, sex and clinical experience from residents who started the GP training in Utrecht, the Netherlands, in the period March 2005-August 2007. We also collected competence scores from the domains 'medical expertise', 'doctor-patient communication' and 'professionalism', as well as scores on a national GP knowledge test. The outcome measures were 'poor performance' and 'forced attrition'. Multivariate logistic regression was used to analyse correlations between personal characteristics, competence scores on the 3 domains and knowledge scores in the first trimester on the one hand and poor performance or forced attrition on the other. 215 residents started the GP training. In the first trimester a quarter of the residents had an insufficient score in 1 or more of the domains. Competence scores were mutually correlated, but did not correlate with the knowledge score. 18 residents showed poor performance and 3 were forced to stop their training. Poor performance and forced attrition were correlated with age (adjusted odds ratio (OR): 1.1; 95% CI: 1.0-1.3), insufficient knowledge (adjusted OR: 8.9; 3.0-26.3) and medical expertise (adjusted OR: 2.1; 1.1-4.0) at the beginning of the training. Age, insufficient knowledge of general practice, and insufficient competence in the domain of 'medical expertise' at the beginning of the training are risk factors for poor performance by residents and attrition from their GP training.

  8. General Practitioners’ Attitudes towards Essential Competencies in End-of-Life Care: A Cross-Sectional Survey

    PubMed Central

    Giezendanner, Stéphanie; Jung, Corinna; Banderet, Hans-Ruedi; Otte, Ina Carola; Gudat, Heike; Haller, Dagmar M.; Elger, Bernice S.; Zemp, Elisabeth; Bally, Klaus

    2017-01-01

    Background Identifying essential competencies in end-of-life care, as well as general practitioners’ (GPs) confidence in these competencies, is essential to guide training and quality improvement efforts in this domain. Aim To determine which competencies in end-of-life care are considered important by GPs, to assess GPs’ confidence in these competencies in a European context and their reasons to refer terminally ill patients to a specialist. Design and Setting Cross-sectional postal survey involving a stratified random sample of 2000 GPs in Switzerland in 2014. Method Survey development was informed by a previous qualitative exploration of relevant end-of-life GP competencies. Main outcome measures were GPs’ assessment of the importance of and confidence in 18 attributes of end-of-life care competencies, and reasons for transferring care of terminally-ill patients to a specialist. GP characteristics associated with main outcome measures were tested using multivariate regression models. Results The response rate was 31%. Ninety-nine percent of GPs considered the recognition and treatment of pain as important, 86% felt confident about it. Few GPs felt confident in cultural (16%), spiritual (38%) and legal end-of-life competencies such as responding to patients seeking assisted suicide (35%) although more than half of the respondents regarded these competencies as important. Most frequent reasons to refer terminally ill patients to a specialist were lack of time (30%), better training of specialists (23%) and end-of-life care being incompatible with other duties (19%). In multiple regression analyses, confidence in end-of-life care was positively associated with GPs’ age, practice size, home visits and palliative training. Conclusions GPs considered non-somatic competencies (such as spiritual, cultural, ethical and legal aspects) nearly as important as pain and symptom control. Yet, few GPs felt confident in these non-somatic competencies. These findings

  9. A Study of One Learner Cognitive Style and the Ability to Generalize Behavioral Competencies.

    ERIC Educational Resources Information Center

    Carter, Heather L.

    The generalization of acquired competencies, specifically flexibility of closure, was the subject of this research. Flexibility of closure was defined as the ability to demonstrate selective attention to a specified set of elements when presented within various settings (the larger the number of settings from which the desired set of elements can…

  10. General Shop Competencies in Vocational Agriculture for 9th and 10th Grade Classes.

    ERIC Educational Resources Information Center

    Novotny, Ronald; And Others

    The document presents unit plans which offer list of experiences and competencies to be learned for general shop occupations in vocational agriculture. The units include: (1) arc welding, (2) oxy-acetylene welding, (3) flat concrete, (4) concrete block, (5) lumber patterns and wood building materials, (6) metal fasteners, (7) wood adhesives, (8)…

  11. Determining specific competencies for General Internal Medicine residents (PGY 4 and PGY 5). What are they and are programs currently teaching them? A survey of practicing Canadian General Internists.

    PubMed

    Card, Sharon E; Pausjenssen, Anne M; Ottenbreit, Rachel C

    2011-11-03

    General Internal Medicine (GIM) has recently been approved as a subspecialty by the Royal College of Physicians and Surgeons of Canada. As such, there is a need to define areas of knowledge that a General Internist must learn in those two years of training. There is limited literature as to what competencies are needed in a GIM practice. Draft competencies for GIM (4th and 5th year residents in internal medicine) training were developed over eight years with input from many stakeholders. Practicing General Internists were surveyed and asked their perspective as to the level of importance of each of these competencies for GIM training. They were also asked if training gaps exist in current training programs. The survey was offered widely online in both English and French to gain perspectives from as many different contexts as possible. 157 General Internists, in practice on average for 15 years, responded from all of Canada's provinces and territories. Practice profiles were diverse (large urban centers to rural centers). The majority of the competencies surveyed were perceived as important to attain at least proficiency in. Perioperative care, risk reduction, and the management of common, emergent, and complex internal medicine problems were identified as key areas to focus training programs on, with respondents perceiving these should be mastered to an expert level. Training gaps were identified, most frequently in that of the manager role (example managing practice). This is the first study we are aware of to attempt to isolate the opinions of practicing Canadian General Internists as to the major competencies that should be mastered as a General Internist. We suggest that "generalism" in the context of GIM, does not mean a bit of knowledge about everything but that defined objectives for training in this 'newest' of Royal College subspecialties can be identified. This includes mastery of core areas such as perioperative care, risk reduction, and management of

  12. Service-Based Learning for Residents: A Success for Communities and Medical Education.

    PubMed

    Gefter, Liana; Merrell, Sylvia Bereknyei; Rosas, Lisa G; Morioka-Douglas, Nancy; Rodriguez, Eunice

    2015-01-01

    Community-based service-learning opportunities could support residents' acquisition of Accreditation Council for Graduate Medical Education (ACGME) competencies, but this concept has not been tested, and such programs are difficult to find. The objective of this work was to assess the value and the ACGME competency relevance of a service-learning program for residents that could be easily replicated nationally. Forty-one family medicine residents from three training programs participated in the Stanford Youth Diabetes Coaches Program at six high schools in California and Georgia serving minority students of low socioeconomic status. Residents completed online surveys to provide qualitative feedback and assess the program's impact on their acquisition of residency program competencies and self-management support proficiencies, including prior use and planned use of action plans-a key self-management support strategy. Ninety-five percent of residents indicated that the program was a valuable experience that contributed to acquisition of residency program competencies, including interpersonal and communication skills and communication with teens. Compared with baseline, significantly more residents reported intention to use action plans with patients following participation. Themes from qualitative feedback included: valuing the overall experience, increasing opportunities to practice teaching, enhancing their ability to communicate with adolescents, contributing to the health of the community, recognizing the potential of action plans, and increasing intent to use action plans. This pilot demonstrated that a brief service-learning program can enhance standard residency curriculum by encouraging acquisition of ACGME competencies and promoting utilization of self-management support in clinical practice.

  13. [Competency: general principles and applicability in dementia].

    PubMed

    Alvaro, L C

    2012-06-01

    Competency means the capacity to make responsible and balanced decisions. This may be performed in clinical settings (decision-making abilities on treatment or risky diagnostic procedures) and also in daily-life activities (financial matters, nursing home admittance, contracts, etc.). Competency is linked to the ethical principle of autonomy and to a horizontal doctor-patient interaction, far from ancient paternalistic relationships. It is contemplated in the Spanish law as the patient's right to be informed and to make free choices, particularly in cases of dementia. The competency that we assess is the so-called natural or working capacity. It is specific for an action or task. The level of required capacity depends on the decision: higher for critical ones, lower for low-risk decisions. The assessment process requires noting the patient's capacity to understand, analyse, self-refer and apply the information. There are some guides available that may be useful in competency assessments, but nevertheless the final statement must be defined by the physician in charge of the patient and clinical judgement. Capacity is directly related to the level of cognitive deterioration. Nevertheless, specific cognitive tests like MMSE (mini-mental) have a low predictive value. The loss of competency is more associated with the so-called legal standards of incapacity (LS). These encompass a five steps range (LS1-LS5), which may detect the incapacity from the mild levels of dementia. The cortical functions that are the best predictors of incapacity are language and executive dysfunctions. These explain the incapacity in cases of Alzheimer's and Parkinson's disease, and have been studied more. Incapacity is common and it influences the clinical decision-making process. We must be particularly cautious with clinical trials of dementia. It also involves other areas of daily life, particularly financially related ones, where limitations are present from the mild cognitive impairment

  14. How do clinical competency committees use different sources of data to assess residents' performance on the internal medicine milestones?A mixed methods pilot study.

    PubMed

    Ekpenyong, Andem; Baker, Elizabeth; Harris, Ilene; Tekian, Ara; Abrams, Richard; Reddy, Shalini; Park, Yoon Soo

    2017-10-01

    This study examines how Clinical Competency Committees (CCCs) synthesize assessment data to make judgments about residents' clinical performances. Between 2014 and 2015, after four six-month reporting periods to the Accreditation Council for Graduate Medical Education (ACGME), 7 of 16 CCC faculty at Rush University Medical Center completed questionnaires focused on their perspectives about rating residents on their achievement of the milestones and participated in a focus group. Qualitative data were analyzed using grounded theory. Milestones ratings for two six-month ACGME reporting cycles (n = 100 categorical residents) were also analyzed. CCC members weighted resident rotation ratings highest (weight = 37%), followed by faculty rotation comments (weight = 27%) and personal experience with residents (weight = 14%) for making judgments about learner's milestone levels. Three assessment issues were identified from qualitative analyses: (1) "design issues" (e.g. problems with available data or lack thereof); (2) "synthesis issues" (e.g. factors influencing ratings and decision-making processes) and (3) "impact issues" (e.g. how CCC generated milestones ratings are used). Identifying factors that affect assessment at all stages of the CCC process can contribute to improving assessment systems, including support for faculty development for CCCs. Recognizing challenges in synthesizing first and second-hand assessment data is an important step in understanding the CCC decision-making process.

  15. Impact of the 2011 ACGME resident duty hour reform on hospital patient experience and processes-of-care.

    PubMed

    Rajaram, Ravi; Saadat, Lily; Chung, Jeanette; Dahlke, Allison; Yang, Anthony D; Odell, David D; Bilimoria, Karl Y

    2016-12-01

    In 2011, the Accreditation Council for Graduate Medical Education (ACGME) expanded restrictions on resident duty hours. While studies have shown no association between these restrictions and improved outcomes, process-of-care and patient experience measures may be more sensitive to resident performance, and thus may be impacted by duty hour policies. The objective of this study was to evaluate the association between the 2011 resident duty hour reform and measures of processes-of-care and patient experience. Hospital Consumer Assessment of Healthcare Providers and Systems survey data and process-of-care scores were obtained from the Centers for Medicare and Medicaid Services Hospital Compare website for 1 year prior to (1 July 2010 to 30 June 2011) and 1 year after (1 July 2011 to 30 June 2012) duty hour reform implementation. Using a difference-in-differences model, non-teaching and teaching hospitals were compared before and after the 2011 reform to test the association of this policy with changes in process-of-care and patient experience measure scores. Duty hour reform was not associated with a change in the five patient experience measures evaluated, including patients rating a hospital 9 or 10 (coefficient -0.003, 95% CI -0.79 to 0.79) or stating they would 'definitely recommend' a hospital (coefficient -0.28, 95% CI -1.01 to 0.44). For all 10 process-of-care measures examined, such as antibiotic timing (coefficient -0.462, 95% CI -1.502 to 0.579) and discontinuation (0.188, 95% CI -0.529 to 0.904), duty hour reform was not associated with a change in scores. The 2011 ACGME duty hour reform was not associated with improvements in process-of-care and patient experience measures. These data should be considered when considering reform of resident duty hour policies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. A Longitudinal Emergency Medical Services Track in Emergency Medicine Residency.

    PubMed

    Adams, Daniel; Bischof, Jason; Larrimore, Ashley; Krebs, William; King, Andrew

    2017-03-30

    Emergency medicine residency programs offer Emergency Medical Services (EMS) curricula to address Accreditation Council for Graduate Medical Education (ACGME) milestones. While some programs offer advanced clinical tracks in EMS, no standard curriculum exists. We sought to establish a well-defined EMS curriculum to allow interested residents to develop advanced clinical skills and scholarship within this subspecialty. Core EMS fellowship trained faculty were recruited to help develop the curriculum. Building on ACGME graduation requirements and milestones, important elements of EMS fellowship training were incorporated into the curriculum to develop the final document. The final curriculum focuses on scholarly activities relating to the four core areas of EMS identified by The American Board of Emergency Medicine and serves as an intermediary between ACGME graduation requirements for education in EMS and fellowship level training. Standardization of the EMS scholarly track can provide residents with the potential to obtain competency beyond ACGME requirements and prepare them for success in fellowship training and/or leadership within EMS on graduation.

  17. A Longitudinal Emergency Medical Services Track in Emergency Medicine Residency

    PubMed Central

    Bischof, Jason; Larrimore, Ashley; Krebs, William; King, Andrew

    2017-01-01

    Emergency medicine residency programs offer Emergency Medical Services (EMS) curricula to address Accreditation Council for Graduate Medical Education (ACGME) milestones. While some programs offer advanced clinical tracks in EMS, no standard curriculum exists. We sought to establish a well-defined EMS curriculum to allow interested residents to develop advanced clinical skills and scholarship within this subspecialty. Core EMS fellowship trained faculty were recruited to help develop the curriculum. Building on ACGME graduation requirements and milestones, important elements of EMS fellowship training were incorporated into the curriculum to develop the final document. The final curriculum focuses on scholarly activities relating to the four core areas of EMS identified by The American Board of Emergency Medicine and serves as an intermediary between ACGME graduation requirements for education in EMS and fellowship level training. Standardization of the EMS scholarly track can provide residents with the potential to obtain competency beyond ACGME requirements and prepare them for success in fellowship training and/or leadership within EMS on graduation. PMID:28465874

  18. Use of a structured template to facilitate practice-based learning and improvement projects.

    PubMed

    McClain, Elizabeth K; Babbott, Stewart F; Tsue, Terance T; Girod, Douglas A; Clements, Debora; Gilmer, Lisa; Persons, Diane; Unruh, Greg

    2012-06-01

    The Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to meet and demonstrate outcomes across 6 competencies. Measuring residents' competency in practice-based learning and improvement (PBLI) is particularly challenging. We developed an educational tool to meet ACGME requirements for PBLI. The PBLI template helped programs document quality improvement (QI) projects and supported increased scholarly activity surrounding PBLI learning. We reviewed program requirements for 43 residency and fellowship programs and identified specific PBLI requirements for QI activities. We also examined ACGME Program Information Form responses on PBLI core competency questions surrounding QI projects for program sites visited in 2008-2009. Data were integrated by a multidisciplinary committee to develop a peer-protected PBLI template guiding programs through process, documentation, and evaluation of QI projects. All steps were reviewed and approved through our GME Committee structure. An electronic template, companion checklist, and evaluation form were developed using identified project characteristics to guide programs through the PBLI process and facilitate documentation and evaluation of the process. During a 24 month period, 27 programs have completed PBLI projects, and 15 have reviewed the template with their education committees, but have not initiated projects using the template. The development of the tool generated program leaders' support because the tool enhanced the ability to meet program-specific objectives. The peer-protected status of this document for confidentiality and from discovery has been beneficial for program usage. The document aggregates data on PBLI and QI initiatives, offers opportunities to increase scholarship in QI, and meets the ACGME goal of linking measures to outcomes important to meeting accreditation requirements at the program and institutional level.

  19. Use of a Structured Template to Facilitate Practice-Based Learning and Improvement Projects

    PubMed Central

    McClain, Elizabeth K.; Babbott, Stewart F.; Tsue, Terance T.; Girod, Douglas A.; Clements, Debora; Gilmer, Lisa; Persons, Diane; Unruh, Greg

    2012-01-01

    Background The Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to meet and demonstrate outcomes across 6 competencies. Measuring residents' competency in practice-based learning and improvement (PBLI) is particularly challenging. Purpose We developed an educational tool to meet ACGME requirements for PBLI. The PBLI template helped programs document quality improvement (QI) projects and supported increased scholarly activity surrounding PBLI learning. Methods We reviewed program requirements for 43 residency and fellowship programs and identified specific PBLI requirements for QI activities. We also examined ACGME Program Information Form responses on PBLI core competency questions surrounding QI projects for program sites visited in 2008–2009. Data were integrated by a multidisciplinary committee to develop a peer-protected PBLI template guiding programs through process, documentation, and evaluation of QI projects. All steps were reviewed and approved through our GME Committee structure. Results An electronic template, companion checklist, and evaluation form were developed using identified project characteristics to guide programs through the PBLI process and facilitate documentation and evaluation of the process. During a 24 month period, 27 programs have completed PBLI projects, and 15 have reviewed the template with their education committees, but have not initiated projects using the template. Discussion The development of the tool generated program leaders' support because the tool enhanced the ability to meet program-specific objectives. The peer-protected status of this document for confidentiality and from discovery has been beneficial for program usage. The document aggregates data on PBLI and QI initiatives, offers opportunities to increase scholarship in QI, and meets the ACGME goal of linking measures to outcomes important to meeting accreditation requirements at the program and institutional level. PMID

  20. Competencies as the basis for reformed premedical education. The case for an unrestricted liberal arts collegiate education.

    PubMed

    Kase, Nathan; Muller, David

    2012-01-01

    As the HHMI-AAMC declared, their report should be taken as a "first step in a continuing conversation about the appropriate skills and knowledge," and, echoing the ACGME and GPEP, "values and attitudes that future physicians should possess." (9pExecSum) As a new formulation evolves, the premedical curriculum must foster "scholastic vigor, analytic thinking, quantitative assessment and analysis of complex systems." (9pExecSum) Based on the Mount Sinai experience, these qualities are not engendered solely nor confined to engagement in natural sciences. Students involved in a variety of baccalaureate liberal arts endeavors appear to acquire similar intellectual competencies. Furthermore, when performed successfully in challenging collegiate environments, a thorough liberal arts education may yield precisely the same values, attitudes, and behavioral characteristics all agree are essential to the medical profession and preparing physicians for the twenty-first century.

  1. Identifying and Eliminating Deficiencies in the General Surgery Resident Core Competency Curriculum.

    PubMed

    Tapia, Nicole M; Milewicz, Allen; Whitney, Stephen E; Liang, Michael K; Braxton, Carla C

    2014-06-01

    Although the Accreditation Council for Graduate Medical Education has defined 6 core competencies required of resident education, no consensus exists on best practices for reaching resident proficiency. Surgery programs must develop resourceful methods to incorporate learning. While patient care and medical knowledge are approached with formal didactics and traditional Halstedian educational formats, other core competencies are presumed to be learned on the job or emphasized in conferences. To test the hypothesis that our residents lack a foundation in several of the nonclinical core competencies and to seek to develop a formal curriculum that can be integrated into our current didactic time, with minimal effect on resident work hours and rest hours. Anonymous Likert-type scale needs assessment survey requesting residents within a large single general surgery residency program to rate their understanding, working knowledge, or level of comfort on the following 10 topics: negotiation and conflict resolution; leadership styles; health care legislation; principles of quality delivery of care, patient safety, and performance improvement; business of medicine; clinical practice models; role of advocacy in health care policy and government; personal finance management; team building; and roles of innovation and technology in health care delivery. Proportions of resident responses scored as positive (agree or strongly agree) or negative (disagree or strongly disagree). In total, 48 surgery residents (70%) responded to the survey. Only 3 topics (leadership styles, team building, and roles of innovation and technology in health care delivery) had greater than 70% positive responses, while 2 topics (negotiation and conflict resolution and principles of quality delivery of care, patient safety, and performance improvement) had greater than 60% positive responses. The remaining topics had less than 40% positive responses, with the least positive responses on the topics

  2. Are Generalized Anxiety and Depression Symptoms Associated with Social Competence in Children with and without Autism Spectrum Disorder?

    ERIC Educational Resources Information Center

    Johnston, Krista Haley Smith; Iarocci, Grace

    2017-01-01

    Generalized anxiety and depression symptoms may be associated with poorer social outcomes among children with Autism Spectrum Disorder (ASD) without intellectual disability. The goal of this study was to examine whether generalized anxiety and depression symptoms were associated with social competence after accounting for IQ, age, and gender in…

  3. Educational Milestone Development in the First 7 Specialties to Enter the Next Accreditation System

    PubMed Central

    Swing, Susan R.; Beeson, Michael S.; Carraccio, Carol; Coburn, Michael; Iobst, William; Selden, Nathan R.; Stern, Peter J.; Vydareny, Kay

    2013-01-01

    Background The Accreditation Council for Graduate Medical Education (ACGME) Outcome Project introduced 6 general competencies relevant to medical practice but fell short of its goal to create a robust assessment system that would allow program accreditation based on outcomes. In response, the ACGME, the specialty boards, and other stakeholders collaborated to develop educational milestones, observable steps in residents' professional development that describe progress from entry to graduation and beyond. Objectives We summarize the development of the milestones, focusing on 7 specialties, moving to the next accreditation system in July 2013, and offer evidence of their validity. Methods Specialty workgroups with broad representation used a 5-level developmental framework and incorporated information from literature reviews, specialty curricula, dialogue with constituents, and pilot testing. Results The workgroups produced richly diverse sets of milestones that reflect the community's consideration of attributes of competence relevant to practice in the given specialty. Both their development process and the milestones themselves establish a validity argument, when contemporary views of validity for complex performance assessment are used. Conclusions Initial evidence for validity emerges from the development processes and the resulting milestones. Further advancing a validity argument will require research on the use of milestone data in resident assessment and program accreditation. PMID:24404235

  4. Emergency medicine point-of-care ultrasonography: a national needs assessment of competencies for general and expert practice.

    PubMed

    Fischer, Lisa M; Woo, Michael Y; Lee, A Curtis; Wiss, Ray; Socransky, Steve; Frank, Jason R

    2015-01-01

    Emergency medicine point-of-care ultrasonography (EM-PoCUS) is a core competency for residents in the Royal College of Physicians and Surgeons of Canada and College of Family Physicians of Canada emergency medicine (EM) training programs. Although EM-PoCUS fellowships are currently offered in Canada, there is little consensus regarding what training should be included in a Canadian EM-PoCUS fellowship curriculum or how this contrasts with the training received in an EM residency.Objectives To conduct a systematic needs assessment of major stakeholders to define the essential elements necessary for a Canadian EM-PoCUS fellowship training curriculum. We carried out a national survey of experts in EM-PoCUS, EM residency program directors, and EM residents. Respondents were asked to identify competencies deemed either nonessential to EM practice, essential for general EM practice, essential for advanced EM practice, or essential for EM-PoCUS fellowship trained (‘‘expert’’) practice. The response rate was 81% (351 of 435). PoCUS was deemed essential to general EM practice for basic cardiac, aortic, trauma, and procedural imaging. PoCUS was deemed essential to advanced EM practice in undifferentiated symptomatology, advanced chest pathologies, and advanced procedural applications. Expert-level PoCUS competencies were identified for administrative, pediatric, and advanced gynecologic applications. Eighty-seven percent of respondents indicated that there was a need for EM-PoCUS fellowships, with an ideal length of 6 months. This is the first needs assessment of major stakeholders in Canada to identify competencies for expert training in EM-PoCUS. The competencies should form the basis for EM-PoCUS fellowship programs in Canada.

  5. Danish general practitioners’ self-reported competences in end-of-life care

    PubMed Central

    Winthereik, Anna; Neergaard, Mette; Vedsted, Peter; Jensen, Anders

    2016-01-01

    Objective General practitioners (GPs) are pivotal in end-of-life (EOL) care. This study aimed to assess GP-reported provision of EOL care and to assess associations with GP characteristics. Design Population-based questionnaire study. Setting Central Denmark Region with approximately 1.3 million inhabitants. Subjects All 843 active GPs in the Central Denmark Region were sent a questionnaire by mail. Main outcome measures Responses to 18 items concerning four aspects: provision of EOL care to patients with different diagnosis, confidence with being a key worker, organisation of EOL care and EOL skills (medical and psychosocial). Results In total, 573 (68%) GPs responded. Of these, 85% often/always offered EOL care to cancer patients, which was twice as often as to patients with non-malignancies (34–40%). Moreover, 76% felt confident about being a key worker, 60% had a proactive approach, and 58% talked to their patients about dying. Only 9% kept a register of patients with EOL needs, and 19% had specific EOL procedures. GP confidence with own EOL skills varied; from 55% feeling confident using terminal medications to 90% feeling confident treating nausea/vomiting. Increasing GP age was associated with increased confidence about being a key worker and provision of EOL care to patients with non-malignancies. In rural areas, GPs were more confident about administering medicine subcutaneously than in urban areas. Conclusion We found considerable diversity in self-reported EOL care competences. Interventions should focus on increasing GPs’ provision of EOL care to patients with non-malignancies, promoting better EOL care concerning organisation and symptom management. KEY POINTSGPs are pivotal in end-of-life (EOL) care, but their involvement has been questioned. Hence, GPs’ perceived competencies were explored.GPs were twice as likely to provide EOL care for patients with cancer than for patients with non-malignancies.EOL care was lacking clear organisation in

  6. Danish general practitioners' self-reported competences in end-of-life care.

    PubMed

    Winthereik, Anna; Neergaard, Mette; Vedsted, Peter; Jensen, Anders

    2016-12-01

    General practitioners (GPs) are pivotal in end-of-life (EOL) care. This study aimed to assess GP-reported provision of EOL care and to assess associations with GP characteristics. Population-based questionnaire study. Central Denmark Region with approximately 1.3 million inhabitants. All 843 active GPs in the Central Denmark Region were sent a questionnaire by mail. Responses to 18 items concerning four aspects: provision of EOL care to patients with different diagnosis, confidence with being a key worker, organisation of EOL care and EOL skills (medical and psychosocial). In total, 573 (68%) GPs responded. Of these, 85% often/always offered EOL care to cancer patients, which was twice as often as to patients with non-malignancies (34-40%). Moreover, 76% felt confident about being a key worker, 60% had a proactive approach, and 58% talked to their patients about dying. Only 9% kept a register of patients with EOL needs, and 19% had specific EOL procedures. GP confidence with own EOL skills varied; from 55% feeling confident using terminal medications to 90% feeling confident treating nausea/vomiting. Increasing GP age was associated with increased confidence about being a key worker and provision of EOL care to patients with non-malignancies. In rural areas, GPs were more confident about administering medicine subcutaneously than in urban areas. We found considerable diversity in self-reported EOL care competences. Interventions should focus on increasing GPs' provision of EOL care to patients with non-malignancies, promoting better EOL care concerning organisation and symptom management. KEY POINTS GPs are pivotal in end-of-life (EOL) care, but their involvement has been questioned. Hence, GPs' perceived competencies were explored. GPs were twice as likely to provide EOL care for patients with cancer than for patients with non-malignancies. EOL care was lacking clear organisation in general practice in terms of registering palliative patients and having specific

  7. Setting Performance Standards for Technical and Nontechnical Competence in General Surgery.

    PubMed

    Szasz, Peter; Bonrath, Esther M; Louridas, Marisa; Fecso, Andras B; Howe, Brett; Fehr, Adam; Ott, Michael; Mack, Lloyd A; Harris, Kenneth A; Grantcharov, Teodor P

    2017-07-01

    The objectives of this study were to (1) create a technical and nontechnical performance standard for the laparoscopic cholecystectomy, (2) assess the classification accuracy and (3) credibility of these standards, (4) determine a trainees' ability to meet both standards concurrently, and (5) delineate factors that predict standard acquisition. Scores on performance assessments are difficult to interpret in the absence of established standards. Trained raters observed General Surgery residents performing laparoscopic cholecystectomies using the Objective Structured Assessment of Technical Skill (OSATS) and the Objective Structured Assessment of Non-Technical Skills (OSANTS) instruments, while as also providing a global competent/noncompetent decision for each performance. The global decision was used to divide the trainees into 2 contrasting groups and the OSATS or OSANTS scores were graphed per group to determine the performance standard. Parametric statistics were used to determine classification accuracy and concurrent standard acquisition, receiver operator characteristic (ROC) curves were used to delineate predictive factors. Thirty-six trainees were observed 101 times. The technical standard was an OSATS of 21.04/35.00 and the nontechnical standard an OSANTS of 22.49/35.00. Applying these standards, competent/noncompetent trainees could be discriminated in 94% of technical and 95% of nontechnical performances (P < 0.001). A 21% discordance between technically and nontechnically competent trainees was identified (P < 0.001). ROC analysis demonstrated case experience and trainee level were both able to predict achieving the standards with an area under the curve (AUC) between 0.83 and 0.96 (P < 0.001). The present study presents defensible standards for technical and nontechnical performance. Such standards are imperative to implementing summative assessments into surgical training.

  8. Adult Competency Education Kit. Basic Skills in Speaking, Math, and Reading for Employment. Part R. ACE Competency Based Job Descriptions: #95--Bus Driver; #98--General Loader; #99--Forklift Operator; #100--Material Handler.

    ERIC Educational Resources Information Center

    San Mateo County Office of Education, Redwood City, CA. Career Preparation Centers.

    This fifteenth of fifteen sets of Adult Competency Education (ACE) Competency Based Job Descriptions in the ACE kit contains job descriptions for Bus Driver, General Loader, Forklift Operator, and Material Handler. Each begins with a fact sheet that includes this information: occupational title, D.O.T. code, ACE number, career ladder, D.O.T.…

  9. Milestones for the Final Mile: Interspecialty Distinctions in Primary Palliative Care Skills Training.

    PubMed

    Harris, John A; Herrel, Lindsey A; Healy, Mark A; Wancata, Lauren M; Perumalswami, Chithra R

    2016-09-01

    Primary palliative care (PPC) skills are useful in a wide variety of medical and surgical specialties, and the expectations of PPC skill training are unknown across graduate medical education. We characterized the variation and quality of PPC skills in residency outcomes-based Accreditation Council for Graduate Medical Education (ACGME) milestones. We performed a content analysis with structured implicit review of 2015 ACGME milestone documents from 14 medical and surgical specialties chosen for their exposure to clinical situations requiring PPC. For each specialty milestone document, we characterized the variation and quality of PPC skills in residency outcomes-based ACGME milestones. We identified 959 occurrences of 29 palliative search terms within 14 specialty milestone documents. Within these milestone documents, implicit review characterized 104 milestones with direct saliency to PPC skills and 196 milestones with indirect saliency. Initial interrater agreement of the saliency rating among the primary reviewers was 89%. Specialty milestone documents varied widely in their incorporation of PPC skills within milestone documents. PPC milestones were most commonly found in milestone documents for Anesthesiology, Pediatrics, Urology, and Physical Medicine and Rehabilitation. PPC-relevant milestones were most commonly found in the Interpersonal and Communication Skills core competency with 108 (36%) relevant milestones classified under this core competency. Future revisions of specialty-specific ACGME milestone documents should focus on currently underrepresented, but important PPC skills. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  10. Effects of Technological Advances in Surgical Education on Quantitative Outcomes From Residency Programs.

    PubMed

    Dietl, Charles A; Russell, John C

    2016-01-01

    The purpose of this article is to review the literature on current technology for surgical education and to evaluate the effect of technological advances on the Accreditation Council of Graduate Medical Education (ACGME) Core Competencies, American Board of Surgery In-Training Examination (ABSITE) scores, and American Board of Surgery (ABS) certification. A literature search was obtained from MEDLINE via PubMed.gov, ScienceDirect.com, and Google Scholar on all peer-reviewed studies published since 2003 using the following search queries: technology for surgical education, simulation-based surgical training, simulation-based nontechnical skills (NTS) training, ACGME Core Competencies, ABSITE scores, and ABS pass rate. Our initial search list included the following: 648 on technology for surgical education, 413 on simulation-based surgical training, 51 on simulation-based NTS training, 78 on ABSITE scores, and 33 on ABS pass rate. Further, 42 articles on technological advances for surgical education met inclusion criteria based on their effect on ACGME Core Competencies, ABSITE scores, and ABS certification. Systematic review showed that 33 of 42 and 26 of 42 publications on technological advances for surgical education showed objective improvements regarding patient care and medical knowledge, respectively, whereas only 2 of 42 publications showed improved ABSITE scores, but none showed improved ABS pass rates. Improvements in the other ACGME core competencies were documented in 14 studies, 9 of which were on simulation-based NTS training. Most of the studies on technological advances for surgical education have shown a positive effect on patient care and medical knowledge. However, the effect of simulation-based surgical training and simulation-based NTS training on ABSITE scores and ABS certification has not been assessed. Studies on technological advances in surgical education and simulation-based NTS training showing quantitative evidence that surgery residency

  11. Accreditation Council for Graduate Medical Education Case Log: General Surgery Resident Thoracic Surgery Experience

    PubMed Central

    Kansier, Nicole; Varghese, Thomas K.; Verrier, Edward D.; Drake, F. Thurston; Gow, Kenneth W.

    2014-01-01

    Background General surgery resident training has changed dramatically over the past 2 decades, with likely impact on specialty exposure. We sought to assess trends in general surgery resident exposure to thoracic surgery using the Accreditation Council for Graduate Medical Education (ACGME) case logs over time. Methods The ACGME case logs for graduating general surgery residents were reviewed from academic year (AY) 1989–1990 to 2011–2012 for defined thoracic surgery cases. Data were divided into 5 eras of training for comparison: I, AY89 to 93; II, AY93 to 98; III, AY98 to 03; IV, AY03 to 08; V, AY08 to 12. We analyzed quantity and types of cases per time period. Student t tests compared averages among the time periods with significance at a p values less than 0.05. Results A total of 21,803,843 general surgery cases were reviewed over the 23-year period. Residents averaged 33.6 thoracic cases each in period I and 39.7 in period V. Thoracic cases accounted for nearly 4% of total cases performed annually (period I 3.7% [134,550 of 3,598,574]; period V 4.1% [167,957 of 4,077,939]). For the 3 most frequently performed procedures there was a statistically significant increase in thoracoscopic approach from period II to period V. Conclusions General surgery trainees today have the same volume of thoracic surgery exposure as their counterparts over the last 2 decades. This maintenance in caseload has occurred in spite of work-hour restrictions. However, general surgery graduates have a different thoracic surgery skill set at the end of their training, due to the predominance of minimally invasive techniques. Thoracic surgery educators should take into account these differences when training future cardiothoracic surgeons. PMID:24968766

  12. A short questionnaire to assess pediatric resident’s competencies: the validation process

    PubMed Central

    2013-01-01

    Background In order to help assess resident performance during training, the Residency Affair Committee of the Pediatric Residency Program of the University of Padua (Italy) administered a Resident Assessment Questionnaire (ReAQ), which both residents and faculty were asked to complete. The aim of this article is to present the ReAQ and its validation. Methods The ReAQ consists of 20 items that assess the six core competencies identified by the Accreditation Council of Graduate Medical Education (ACGME). A many-facet Rasch measurement analysis was used for validating the ReAQ. Results Between July 2011 and June 2012, 211 evaluations were collected from residents and faculty. Two items were removed because their functioning changed with the gender of respondents. The step calibrations were ordered. The self evaluations (residents rating themselves) positively correlated with the hetero evaluations (faculty rating residents; Spearman’s ρ = 0.75, p < 0.001). Unfortunately, the observed agreement among faculty was smaller than expected (Exp = 47.1%; Obs = 41%), which indicates that no enough training to faculty for using the tool was provided. Conclusions In its final form, the ReAQ provides a valid unidimensional measure of core competences in pediatric residents. It produces reliable measures, distinguishes among groups of residents according to different levels of performance, and provides a resident evaluation that holds an analogous meaning for residents and faculty. PMID:23830041

  13. Competency-Based Training & Competency-Based Assessment: "Out of the Frying Pan and into...?"

    ERIC Educational Resources Information Center

    Davison, Trevor

    A major initiative in Australia is a general and pervasive obsession with competency-based training and assessment. There is a real danger that the selling of competency-based training (CBT) and competency-based assessment (CBA) is greater than what it can offer. One criticism focuses on CBT, the other on CBA, although in most instances where CBT…

  14. Adjudicative Competence

    PubMed Central

    Dawes, Sharron E.; Palmer, Barton W.; Jeste, Dilip V.

    2008-01-01

    Purpose of review Although the basic standards of adjudicative competence were specified by the U.S. Supreme Court in 1960, there remain a number of complex conceptual and practical issues in interpreting and applying these standards. In this report we provide a brief overview regarding the general concept of adjudicative competence and its assessment, as well as some highlights of recent empirical studies on this topic. Findings Most adjudicative competence assessments are conducted by psychiatrists or psychologists. There are no universal certification requirements, but some states are moving toward required certification of forensic expertise for those conducting such assessments. Recent data indicate inconsistencies in application of the existing standards even among forensic experts, but the recent publication of consensus guidelines may foster improvements in this arena. There are also ongoing efforts to develop and validate structured instruments to aid competency evaluations. Telemedicine-based competency interviews may facilitate evaluation by those with specific expertise for evaluation of complex cases. There is also interest in empirical development of educational methods to enhance adjudicative competence. Summary Adjudicative competence may be difficult to measure accurately, but the assessments and tools available are advancing. More research is needed on methods of enhancing decisional capacity among those with impaired competence. PMID:18650693

  15. Competency Testing. An Annotated Bibliography.

    ERIC Educational Resources Information Center

    Jackson, Michael; Battiste, Barbara

    Competency testing for either graduation from high school, or as a method for assessing whether a student should advance to a higher grade level, is the focus of this annotated bibliography. Included are annotations that relate to accountability, competency testing, program descriptions where competency testing is utilized, general testing…

  16. ASDS Cosmetic Dermatologic Surgery Fellowship Milestones.

    PubMed

    Waldman, Abigail; Arndt, Kenneth A; Avram, Mathew M; Brown, Mariah R; Dover, Jeffrey S; Fabi, Sabrina G; Friedmann, Daniel P; Geronemus, Roy G; Goldberg, David J; Goldman, Mitchel P; Green, Jeremy B; Ibrahimi, Omar A; Jones, Derek H; Kilmer, Suzanne L; McDaniel, David H; Obagi, Suzan; Ortiz, Arisa E; Rohrer, Thomas E; Taylor, Mark B; Torres, Abel; Weinkle, Susan H; Weiss, Margaret A; Weiss, Eduardo T; Weiss, Robert A; Poon, Emily; Alam, Murad

    2016-10-01

    The American Council of Graduate Medical Education, which oversees much of postgraduate medical education in the United States, has championed the concept of "milestones," standard levels of achievement keyed to particular time points, to assess trainee performance during residency. To develop a milestones document for the American Society for Dermatologic Surgery (ASDS) Cosmetic Dermatologic Surgery (CDS) fellowship program. An ad hoc milestone drafting committee was convened that included members of the ASDS Accreditation Work Group and program directors of ASDS-approved Cosmetic Dermatologic Surgery (CDC) fellowship training programs. Draft milestones were circulated through email in multiple rounds until consensus was achieved. Thirteen milestones were developed in the 6 Accreditation Council for Graduate Medical Education (ACGME) competency areas, with 8 of these being patient-care milestones. Additional instructions for milestone administration more specific to the CDS fellowship than general ACGME instructions were also approved. Implementation of semiannual milestones was scheduled for the fellowship class entering in July 2018. Milestones are now available for CDS fellowship directors to implement in combination with other tools for fellow evaluation.

  17. Training on the DSM-5 Cultural Formulation Interview improves cultural competence in general psychiatry residents: A pilot study.

    PubMed

    Mills, Stacia; Xiao, Anna Q; Wolitzky-Taylor, Kate; Lim, Russell; Lu, Francis G

    2017-04-01

    The objective of this study was to assess whether a 1-hour didactic session on the DSM-5 Cultural Formulation Interview (CFI) improves the cultural competence of general psychiatry residents. The main hypothesis was that teaching adult psychiatry residents a 1-hour session on the CFI would improve cultural competence. The exploratory hypothesis was that trainees with more experience in cultural diversity would have a greater increase in cultural competency scores. Psychiatry residents at a metropolitan, county hospital completed demographics and preintervention questionnaires, were exposed to a 1-hour session on the CFI, and were given a postintervention questionnaire. The questionnaire was an adapted version of the validated Cultural Competence Assessment Tool . Paired samples t tests compared pre- to posttest change. Hierarchical linear regression assessed whether pretraining characteristics predicted posttest scores. The mean change of total pre- and posttest scores was significant ( p = .002), as was the mean change in subscales Nonverbal Communications ( p < .001) and Cultural Knowledge ( p = .002). Demographic characteristics did not predict higher posttest scores (when covarying for pretest scores). Psychiatry residents' cultural competence scores improved irrespective of previous experience in cultural diversity. More research is needed to further explore the implications of the improved scores in clinical practice.

  18. Development of Structural Components of Future Technicians' Professional Competencies during Their Studies of General Disciplines in College

    ERIC Educational Resources Information Center

    Kopilov, Sergey N.; Dorozhkin, Evgenij M.; Tarasyuk, Olga V.; Osipova, Irina V.; Lazareva, Natalia V.

    2016-01-01

    The relevance of the problem stems from the necessity to develop and implement the formation model for structural components of future technicians' professional competencies during their studies of general professional disciplines. The purpose of the article is to carry out a theoretical study, to develop and approbate a model that forms the…

  19. Competency Testing for Pediatric Cardiology Fellows Learning Transthoracic Echocardiography: Implementation, Fellow Experience, and Lessons Learned.

    PubMed

    Levine, Jami C; Geva, Tal; Brown, David W

    2015-12-01

    There is currently great interest in measuring trainee competency at all levels of medical education. In 2007, we implemented a system for assessing cardiology fellows' progress in attaining imaging skills. This paradigm could be adapted for use by other cardiology programs. Evaluation consisted of a two-part exercise performed after years 1 and 2 of pediatric cardiology training. Part 1: a directly observed evaluation of technical skills as fellows imaged a normal subject (year 1) and a patient with complex heart disease (year 2). Part 2: fellows interpreted and wrote reports for two echocardiograms illustrating congenital heart disease. These were graded for accuracy and facility with communicating pertinent data. After 5 years of testing, fellows were surveyed about their experience. In 5 years, 40 fellows were tested at least once. Testing identified four fellows who underperformed on the technical portion and four on the interpretive portion. Surveys were completed by 33 fellows (83 %). Most (67 %) felt that intermittent observation by faculty was inadequate for assessing skills and that procedural volume was a poor surrogate for competency (58 %). Posttest feedback was constructive and valuable for 90, and 70 % felt the process helped them set goals for skill improvement. Overall, fellows felt this testing was fair and should continue. Fellow performance and responses identified programmatic issues that were creating barriers to learning. We describe a practical test to assess competency for cardiology fellows learning echocardiography. This paradigm is feasible, has excellent acceptance among trainees, and identifies trainees who need support. Materials developed could be easily adapted to help track upcoming ACGME-mandated metrics.

  20. Local and national trends in general surgery residents' operative experience: do work hour limitations negatively affect case volume in small community-based programs?

    PubMed

    Markelov, Alexey; Sakharpe, Aniket; Kohli, Harjeet; Livert, David

    2011-12-01

    The goals of this study were to analyze the impact of work hour restrictions on the operative case volume at a small community-based general surgery residency training program and compare changes with the national level. Annual national resident case log data from Accreditation Council for Graduate Medical Education (ACGME) website and case logs of graduating Easton Hospital residents (years 2002-2009) were used for analysis. Weighted average change in total number of cases in our institution was -1.20 (P = 0.52) vs 1.78 (P = 0.07) for the national program average with statistically significant difference on comparison (P = 0.027). We also found significant difference in case volume changes at the national level compared with our institution for the following ACGME defined subcategories: alimentary tract [8.19 (P < 0.01) vs -1.08 (P = 0.54)], abdomen [8.48 (P < 0.01) vs -6.29 (P < 0.01)], breast [1.91 (P = 0.89) vs -3.6 (P = 0.02)], and vascular [4.03 (P = 0.02) vs -3.98 (P = 0.01)]. Comparing the national trend to the community hospital we see that there is total increase in cases at the national level whereas there is a decrease in case volume at the community hospital. These trends can also be followed in ACGME defined subcategories which form the major case load for a general surgical training such as alimentary tract, abdominal, breast, and vascular procedures. We hypothesize that work hour restrictions have been favorable for the larger programs, as these programs were able to better integrate the night float system, restructure their call schedule, and implement institutional modifications which are too resource demanding for smaller training programs.

  1. Investigation of Entrepreneurship Trends and General Competency Levels of University Students Studying at Faculty of Sports Sciences

    ERIC Educational Resources Information Center

    Karabulut, Ebru Olcay; Dogan, Pinar Karacan

    2018-01-01

    The aim of this study is to determine the general competency beliefs and entrepreneurial levels of undergraduate students studying at faculty of sports sciences by different demographic variables. The sample group consists of total 1230 students, 541 women and 689 men, who have been educated in the sport sciences of five different universities and…

  2. Are the General Medical Council's Tests of Competence fair to long standing doctors? A retrospective cohort study.

    PubMed

    Mehdizadeh, Leila; Sturrock, Alison; Dacre, Jane

    2015-04-21

    The General Medical Council's Fitness to Practise investigations may involve a test of competence for doctors with performance concerns. Concern has been raised about the suitability of the test format for doctors who qualified before the introduction of Single Best Answer and Objective Structured Clinical Examination assessments, both of which form the test of competence. This study explored whether the examination formats used in the tests of competence are fair to long standing doctors who have undergone fitness to practise investigation. A retrospective cohort design was used to determine an association between year of primary medical qualification and doctors' test of competence performance. Performance of 95 general practitioners under investigation was compared with a group of 376 volunteer doctors. We analysed performance on knowledge test, OSCE overall, and three individual OSCE stations using Spearman's correlation and regression models. Doctors under investigation performed worse on all test outcomes compared to the comparison group. Qualification year correlated positively with performance on all outcomes except for physical examination (e.g. knowledge test r = 0.48, p < 0.001 and OSCE r = 0.37, p < 0.001). Qualification year was associated with test performance in doctors under investigation even when controlling for sex, ethnicity and qualification region. Regression analyses showed that qualification year was associated with knowledge test, OSCE and communication skills performance of doctors under investigation when other variables were controlled for. Among volunteer doctors this was not the case and their performance was more strongly related to where they qualified and their ethnic background. Furthermore, volunteer doctors who qualified before the introduction of Single Best Answer and OSCE assessments, still outperformed their peers under investigation. Earlier graduates under fitness to practise investigation performed less

  3. Perceived competence and attitudes towards patients with suicidal behaviour: a survey of general practitioners, psychiatrists and internists

    PubMed Central

    2014-01-01

    Background Competence and attitudes to suicidal behaviour among physicians are important to provide high-quality care for a large patient group. The aim was to study different physicians’ attitudes towards suicidal behaviour and their perceived competence to care for suicidal patients. Methods A random selection (n = 750) of all registered General Practitioners, Psychiatrists and Internists in Norway received a questionnaire. The response rate was 40%. The Understanding of Suicidal Patients Scale (USP; scores < 23 = positive attitude) and items about suicide in case of incurable illness from the Attitudes Towards Suicide Questionnaire were used. Five-point Likert scales were used to measure self-perceived competence, level of commitment, empathy and irritation felt towards patients with somatic and psychiatric diagnoses. Questions about training were included. Results The physicians held positive attitudes towards suicide attempters (USP = 20.3, 95% CI: 19.6–20.9). Internists and males were significantly less positive. There were no significant differences in the physicians in their attitudes toward suicide in case of incurable illness according to specialty. The physicians were most irritated and less committed to substance misuse patients. Self perceived competence was relatively high. Forty-three percent had participated in courses about suicide assessment and treatment. Conclusions The physicians reported positive attitudes and relatively high competence. They were least committed to treat patients with substance misuse. None of the professional groups thought that patients with incurable illness should be given help to commit suicide. Further customized education with focus on substance misuse might be useful. PMID:24886154

  4. Perceived competence and attitudes towards patients with suicidal behaviour: a survey of general practitioners, psychiatrists and internists.

    PubMed

    Grimholt, Tine K; Haavet, Ole R; Jacobsen, Dag; Sandvik, Leiv; Ekeberg, Oivind

    2014-05-08

    Competence and attitudes to suicidal behaviour among physicians are important to provide high-quality care for a large patient group. The aim was to study different physicians' attitudes towards suicidal behaviour and their perceived competence to care for suicidal patients. A random selection (n = 750) of all registered General Practitioners, Psychiatrists and Internists in Norway received a questionnaire. The response rate was 40%. The Understanding of Suicidal Patients Scale (USP; scores < 23 = positive attitude) and items about suicide in case of incurable illness from the Attitudes Towards Suicide Questionnaire were used. Five-point Likert scales were used to measure self-perceived competence, level of commitment, empathy and irritation felt towards patients with somatic and psychiatric diagnoses. Questions about training were included. The physicians held positive attitudes towards suicide attempters (USP = 20.3, 95% CI: 19.6-20.9). Internists and males were significantly less positive. There were no significant differences in the physicians in their attitudes toward suicide in case of incurable illness according to specialty. The physicians were most irritated and less committed to substance misuse patients. Self perceived competence was relatively high. Forty-three percent had participated in courses about suicide assessment and treatment. The physicians reported positive attitudes and relatively high competence. They were least committed to treat patients with substance misuse. None of the professional groups thought that patients with incurable illness should be given help to commit suicide. Further customized education with focus on substance misuse might be useful.

  5. Knowledge, competencies and attitudes regarding external post-mortem physical examination: A survey among German post-graduate trainees in general practice.

    PubMed

    Valentini, Jan; Goetz, Katja; Yen, Kathrin; Szecsenyi, Joachim; Dettling, Andrea; Joos, Stefanie; Steinhaeuser, Jost; Flum, Elisabeth

    2018-12-01

    The external post-mortem examination (EPME) is an important medical, legal and socio-economic task with far-reaching relevance; however, due to discrepancies between findings from EPMEs and actual cause of death, improvements in accuracy and quality are needed. To investigate knowledge, competencies and attitudes regarding EPME in general practitioner (GP) post-graduate trainees. Before four post-graduate training courses on the EPME for general practitioner trainees, organized in 2014 in the German federal state of Baden-Wuerttemberg, a questionnaire on the EPME was distributed by the lecturer, completed by the GP post-graduate trainees and returned to the lecturer. The questionnaire consisted of 19 items related to three main categories: knowledge, competencies and attitudes. Out of 380 GP post-graduate trainees, 128 completed and returned the questionnaire (response rate 33.7%). Less than 18% felt adequately confident in identifying a natural cause of death and less than 5% felt adequately confident in identifying an unnatural cause of death. Only 33% consistently fully uncover the corpse for the EPME. We found an important uncertainty in GP post-graduate trainees regarding their EPME knowledge and competencies.

  6. The perspective of the vascular surgery trainee on new ACGME regulations, fatigue, resident training, and patient safety.

    PubMed

    De Martino, Randall R; Brewster, L P; Kokkosis, A A; Glass, C; Boros, M; Kreishman, P; Kauvar, D A; Farber, A

    2011-11-01

    To assess the opinions of vascular surgery trainees on the new Accreditation Council for Graduate Medical Education (ACGME) guidelines. A questionnaire was developed and electronically distributed to trainee members of the Society for Vascular Surgery. Of 238 eligible vascular trainees, 38 (16%) participated. Respondents were predominantly 30 to 35 years of age (47%), male (69%), in 2-year fellowship (73%), and at large academic centers (61%). Trainees report occasionally working while fatigued (63%). Fellows were more likely to report for duty while fatigued (P = .012) than integrated vascular residents. Respondents thought further work-hour restrictions would not improve patient care or training (P < .05) and may not lead to more sleep or improved quality of life. Respondents reported that duty hours should vary by specialty (81%) and allow flexibility in the last years of training (P < .05). Vascular surgery trainees are concerned about further duty-hour restrictions on patient care, education, and training and fatigue mitigation has to be balanced against the need to adequately train vascular surgeons.

  7. Mediational and Deviance Theories of Late High School Failure: Process Roles of Structural Strains, Academic Competence, and General versus Specific Problem Behavior

    ERIC Educational Resources Information Center

    Newcomb, Michael D.; Abbott, Robert D.; Catalano, Richard F.; Hawkins, J. David; Battin-Pearson, Sara; Hill, Karl

    2002-01-01

    Understanding and preventing high school failure is a national priority. Structural strain and general deviance theories attempt to explain late high school failure. The authors tested the hypotheses that general (vs. specific) deviance and academic competence mediate the relationships between structural strain factors (gender, ethnicity, and…

  8. Adult Competency Education Kit. Basic Skills in Speaking, Math, and Reading for Employment. Part N. ACE Competency Based Job Descriptions: #65--Typist I; #67--Grocery Checker; #68--File Clerk; #69--Receptionist; #70--Bank Teller; #71--Clerk, General Office.

    ERIC Educational Resources Information Center

    San Mateo County Office of Education, Redwood City, CA. Career Preparation Centers.

    This eleventh of fifteen sets of Adult Competency Education (ACE) Competency Based Job Descriptions in the ACE kit contains job descriptions for Typist I, Grocery Checker, File Clerk, Receptionist; Bank Teller; and Clerk, General Office. Each begins with a fact sheet that includes this information: occupational title, D.O.T. code, ACE number,…

  9. The role of the nonphysician educator in general surgery residency training: from outcome project and duty-hours restrictions to the next accreditation system and milestones.

    PubMed

    Tarpley, Margaret J; Davidson, Mario A; Tarpley, John L

    2014-01-01

    In 2002 and 2003 the ACGME Outcome Project (assessing residents based on competencies) and duty-hours restrictions were implemented. One strategy for assisting PDs in the increased workload was to hire nonphysician educators with training and experience in curriculum design, teaching techniques, adult learning theories, and research methods. This study sought to document prevalence and responsibilities of nonphysician educators. IRB approval was received for a two-part study. All 247 general surgery PDs were e-mailed the question, "Do you have a nonphysician educator as a member of your surgery education office?" Those who replied "yes" or volunteered "not currently but in the past" were e-mailed a link to an electronic survey concerning the role of the nonphysician educator. Residency training programs in general surgery. General surgery program directors. Of the 126 PDs who responded to the initial query, 37 said "yes" and 4 replied "not currently but in the past". Thirty-two PDs of the initial 41 respondents completed the survey. Significant findings included: 65% were hired in the last 6 years; faculty rank is held by 69%; and curriculum development was the most common responsibility but teaching, research, and administrative duties were often listed. PDs perceived that faculty, residents, and medical students had mostly positive attitudes towards nonphysician educators. The overall results seem to support the notion that nonphysician educators serve as vital members of the team. Copyright © 2014 Association of Program Directors in Surgery. All rights reserved.

  10. Musical Competence is Predicted by Music Training, Cognitive Abilities, and Personality.

    PubMed

    Swaminathan, Swathi; Schellenberg, E Glenn

    2018-06-15

    Individuals differ in musical competence, which we defined as the ability to perceive, remember, and discriminate sequences of tones or beats. We asked whether such differences could be explained by variables other than music training, including socioeconomic status (SES), short-term memory, general cognitive ability, and personality. In a sample of undergraduates, musical competence had positive simple associations with duration of music training, SES, short-term memory, general cognitive ability, and openness-to-experience. When these predictors were considered jointly, musical competence had positive partial associations with music training, general cognitive ability, and openness. Nevertheless, moderation analyses revealed that the partial association between musical competence and music training was evident only among participants who scored below the mean on our measure of general cognitive ability. Moreover, general cognitive ability and openness had indirect associations with musical competence by predicting music training, which in turn predicted musical competence. Musical competence appears to be the result of multiple factors, including but not limited to music training.

  11. Objective Structured Video Examinations (OSVEs) for Geriatrics Education

    ERIC Educational Resources Information Center

    Simpson, Deborah; Gehl, Suzanne; Helm, Robin; Kerwin, Diana; Drewniak, Theresa; Bragg, Dawn St. A.; Ziebert, Monica M.; Denson, Steven; Brown, Diane; Heffron, Mary Gleason; Mitchell, Julie; Harsch, Harold H.; Havas, Nancy; Duthie, Edmund, Jr.; Denson, Kathryn

    2006-01-01

    The Medical College of Wisconsin (MCW) and the Wisconsin Geriatric Education Center (WGEC) are committed to developing educational materials for primary care physicians in training. In response to the opportunity created by the Accreditation Council for Graduate Medical Education (ACGME) competency mandate, an MCW-led interdisciplinary working…

  12. Access to general practice for Pacific peoples: a place for cultural competency.

    PubMed

    Ludeke, Melissa; Puni, Ronald; Cook, Lynley; Pasene, Maria; Abel, Gillian; Sopoaga, Faafetai

    2012-06-01

    Access to primary health care services has been identified as a problem for Pacific peoples. Although cost is the most frequently cited barrier to Pacific service utilisation, some research has indicated that access may also be influenced by features of mainstream primary care services. This study aimed to identify features of mainstream general practice services that act as barriers to accessing these services for Pacific peoples in order to explore strategies that providers could adopt to enable their practices to be more welcoming, accessible and appropriate for Pacific peoples. Pacific participants were recruited through Pacific networks known to Pegasus Health and via 'snowball' sampling. In total, 20 participants participated in one of three focus groups. A semi-structured interview explored the participants' views and experiences of mainstream general practice care. Thematic analysis was utilised to interpret the data. The analysis revealed five themes highlighting non-financial features of mainstream general practice services that may influence the availability and acceptability of these services to Pacific peoples: language and communication; rushed consultations; appointment availability; reception; and Pacific presence. The findings indicate that all personnel within the primary care setting have the ability to directly engage in the improvement of the health status of Pacific peoples in New Zealand by developing cultural competency and incorporating flexibility and diversity into the care and service they provide.

  13. Can professionalism be taught? Encouraging evidence.

    PubMed

    Hochberg, Mark S; Kalet, Adina; Zabar, Sondra; Kachur, Elizabeth; Gillespie, Colleen; Berman, Russell S

    2010-01-01

    Teaching and assessing the Accreditation Council for Graduate Medical Education (ACGME) competencies of Professionalism and Communication have proven to be a challenge for surgical residency training programs. This study used innovative pedagogic approaches and tools in teaching these two competencies. The purpose of this study was to determine whether the learners actually are assimilating and using the concepts and values communicated through this curriculum. A six-station Objective Structured Clinical Examination (OSCE) was designed using standardized patients to create varying Professionalism and Communication scenarios. The surgical resident learners were evaluated using these OSCEs as a baseline. The faculty then facilitated a specially designed curriculum consisting of six interactive sessions focusing on information gathering, rapport building, patient education, delivering bad news, responding to emotion, and interdisciplinary respect. At the conclusion of this curriculum, the surgical resident learners took the same six-station OSCE to determine if their professionalism and communication skills had improved. The surgical resident learners were rated by the standardized patients according to a strict task checklist of criteria at both the precurricular and postcurricular OSCEs. Improvement in the competencies of Professionalism and Communication did achieve statistical significance (P = .029 and P = .011, respectively). This study suggests that the Communication and Professionalism ACGME competencies can be taught to surgical resident learners through a carefully crafted curriculum. Furthermore, these newly learned competencies can affect surgical resident interactions with their patients positively.

  14. Supervision and autonomy of ophthalmology residents in the outpatient Clinic in the United States: a survey of ACGME-accredited programs.

    PubMed

    Singman, Eric L; Srikumaran, Divya; Green, Laura; Tian, Jing; McDonnell, Peter

    2017-06-26

    The development and demonstration of incremental trainee autonomy is required by the ACGME. However, there is scant published research concerning autonomy of ophthalmology residents in the outpatient clinic setting. This study explored the landscape of resident ophthalmology outpatient clinics in the United States. A link to an online survey using the QualtricsTM platform was emailed to the program directors of all 115 ACGME-accredited ophthalmology programs in the United States. Survey questions explored whether resident training programs hosted a continuity clinic where residents would see their own patients, and if so, the degree of faculty supervision provided therein. Metrics such as size of the resident program, number of faculty and clinic setting were also recorded. Correlations between the degree of faculty supervision and other metrics were explored. The response rate was 94%; 69% of respondents indicated that their trainees hosted continuity clinics. Of those programs, 30% required a faculty member to see each patient treated by a resident, while 42% expected the faculty member to at least discuss (if not see) each patient. All programs expected some degree of faculty interaction based upon circumstances such as the level of training of the resident or complexity of the clinical situation. 67% of programs that tracked the contribution of the clinic to resident surgical caseloads reported that these clinics provided more than half of the resident surgical volumes. More ¾ of resident clinics were located in urban settings. The degree of faculty supervision did not correlate to any of the other metrics evaluated. The majority of ophthalmology resident training programs in the United States host a continuity clinic located in an urban environment where residents follow their own patients. Furthermore, most of these clinics require supervising faculty to review both the patients seen and the medical documentation created by the resident encounters. The

  15. The Satter Eating Competence Inventory for Low-income persons is a valid measure of eating competence for persons of higher socioeconomic position.

    PubMed

    Lohse, Barbara

    2015-04-01

    Eating competence is an important behavioral construct, shown to be associated with healthful lifestyle practices, including dietary quality, weight management, physical activity, and sleep duration. A 16-item instrument to measure eating competence, the Satter Eating Competence Inventory was previously validated in a general sample and subsequently, a 16-item instrument was developed to address specific concerns of low-income persons; 12 items were common to both instruments. The purpose of this study was to determine if the low-income version could be applied to a general audience, simplifying intervention evaluation and facilitating cross-study comparison. Both surveys were fully completed by 127 parents (89% white; 35.8 ± 5.3 y; 86% college graduates; 51% eating competent) of preschool-age children; 96 of whom were not considered low-income. Cognitive interviews with 14 parents of varying eating competence levels clarified and confirmed findings. Scores were highly correlated (r = .98) and only 2 of the 96 were not congruently classified for eating competence. Mean difference between the two versions was .24 ± 1.55. The general audience version explained 95% of the variance in the low-income version score. Findings support the low-income version of the Satter Eating Competence Inventory for general audience use as the Satter Eating Competence Inventory 2.0. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. The Road Ahead in Education: Milestones for Geriatric Psychiatry Subspecialty Training.

    PubMed

    Swantek, Sandra S; Maixner, Susan M; Llorente, Maria D; Cheong, Josepha A; Edgar, Laura; Thomas, Christopher R; Ahmed, Iqbal

    2016-09-01

    The Accreditation Council of Graduate Medical Education (ACGME) Milestone Project is the next step in a series of changes revamping the system of graduate medical education. In 2013 the ACGME completed the general psychiatry milestones. The ACGME then pursued creation of milestones for accredited psychiatric subspecialty fellowships. This article documents the work of the geriatric psychiatry subspecialty milestones work group. It reports the history and rationale supporting the milestones, the milestone development process, and the implications for geriatric psychiatry fellowship training. In consultation with the American Association for Geriatric Psychiatry, the American Board of Psychiatry and Neurology, and the ACGME Psychiatry Residency Review Committee, the ACGME appointed a working group to create the geriatric psychiatry milestones using the general psychiatry milestones as a guide. The geriatric psychiatry milestones are the result of an iterative process resulting in the definition of the characteristics vital to a fellowship-trained geriatric psychiatrist. It is premature to assess their effect on psychiatric training. The true impact of the milestones will be determined as each training director uses the milestones to re-evaluate their program curriculum and the educational and clinical learning environment. The ACGME is currently collecting the information about the milestone performance of residents and fellows to further refine and determine how the milestones can best be used to assist programs in improving training. Copyright © 2016 American Association for Geriatric Psychiatry. All rights reserved.

  17. Training on the DSM-5 Cultural Formulation Interview Improves Cultural Competence in General Psychiatry Residents: A Multi-site Study.

    PubMed

    Mills, Stacia; Wolitzky-Taylor, Kate; Xiao, Anna Q; Bourque, Marie Claire; Rojas, Sandra M Peynado; Bhattacharya, Debanjana; Simpson, Annabelle K; Maye, Aleea; Lo, Pachida; Clark, Aaron; Lim, Russell; Lu, Francis G

    2016-10-01

    The authors assessed whether a 1-h didactic session on the DSM-5 Cultural Formulation Interview (CFI) improves cultural competence of general psychiatry residents. Psychiatry residents at six residency programs completed demographics and pre-intervention questionnaires, were exposed to a 1-h session on the CFI, and completed a post-intervention questionnaire. Repeated measures ANCOVA compared pre- to post-intervention change. Linear regression assessed whether previous cultural experience predicted post-intervention scores. Mean scores on the questionnaire significantly changed from pre- to post-intervention (p < 0.001). Previous cultural experience did not predict post-intervention scores. Psychiatry residents' cultural competence scores improved with a 1-h session on the CFI but with notable limitations.

  18. Longitudinal Ultrasound Education Track Curriculum Implemented Within an Emergency Medicine Residency Program.

    PubMed

    Boulger, Creagh; Adams, Daniel Z; Hughes, Daralee; Bahner, David P; King, Andrew

    2017-06-01

    Emergency Medicine residency programs offer ultrasound-focused curricula to address Accreditation Council for Graduate Medical Education (ACGME) milestones. Although some programs offer advanced clinical tracks in ultrasound, no standard curriculum exists. We sought to establish a well-defined ultrasound track curriculum to allow interested residents to develop advanced clinical skills and scholarship within this academic niche. The curriculum involves a greater number of clinical scans, ultrasound-focused scholarly and quality improvement projects, enhanced faculty-driven ultrasound focused didactics, and participation at a national ultrasound conference to receive certification. Successful ultrasound scholarly tracks can provide residents with the potential to obtain fellowships or competency beyond ACGME requirements. © 2017 by the American Institute of Ultrasound in Medicine.

  19. The Feasibility and Effectiveness of a Pilot Resident-Organized and -Led Knowledge Base Review

    ERIC Educational Resources Information Center

    Vautrot, Victor J.; Festin, Fe E.; Bauer, Mark S.

    2010-01-01

    Objective: The Accreditation Council for Graduate Medical Education (ACGME) requires a sufficient medical knowledge base as one of the six core competencies in residency training. The authors judged that an annual "short-course" review of medical knowledge would be a useful adjunct to standard seminar and rotation teaching, and that a…

  20. An Exploration into Learner Experiences with Mandated Learning Portfolios in Graduate Medical Education

    ERIC Educational Resources Information Center

    Mulligan, Margaret H.

    2009-01-01

    In 1999, the Accreditation Council of Graduate Medical Education (ACGME) began the Outcome Project which re-focused program accreditation decisions. Six competency areas detailed new standards, calling for programs to measure and provide evidence of learner's acquisition of the knowledge and skills for independent practice in a specific specialty.…

  1. Evaluating Hospice and Palliative Medicine Education in Pediatric Training Programs.

    PubMed

    Singh, Arun L; Klick, Jeffrey C; McCracken, Courtney E; Hebbar, Kiran B

    2017-08-01

    Hospice and Palliative Medicine (HPM) competencies are of growing importance in training general pediatricians and pediatric sub-specialists. The Accreditation Council for Graduate Medical Education (ACGME) emphasized pediatric trainees should understand the "impact of chronic disease, terminal conditions and death on patients and their families." Currently, very little is known regarding pediatric trainee education in HPM. We surveyed all 486 ACGME-accredited pediatric training program directors (PDs) - 200 in general pediatrics (GP), 57 in cardiology (CARD), 64 in critical care medicine (CCM), 69 in hematology-oncology (ONC) and 96 in neonatology (NICU). We collected training program's demographics, PD's attitudes and educational practices regarding HPM. The complete response rate was 30% (148/486). Overall, 45% offer formal HPM curriculum and 39% offer a rotation in HPM for trainees. HPM teaching modalities commonly reported included conferences, consultations and bedside teaching. Eighty-one percent of all respondents felt that HPM curriculum would improve trainees' ability to care for patients. While most groups felt that a HPM rotation would enhance trainees' education [GP (96%), CARD (77%), CCM (82%) and ONC (95%)], NICU PDs were more divided (55%; p < 0.05 for all comparisons vs. NICU). While most programs report perceived benefit from HPM training, there remains a paucity of opportunities for pediatric trainees. Passive teaching methods are frequently utilized in HPM curricula with minimal diversity in methods utilized to teach HPM. Opportunities to further emphasize HPM in general pediatric and pediatric sub-specialty training remains.

  2. Perceptions of Women Managers and Their Communicator Competencies.

    ERIC Educational Resources Information Center

    Wheeless, Virginia Eman; Berryman-Fink, Cynthia

    1985-01-01

    Examined employee attitudes toward women in general and women as managers, and perceived communication competencies of women managers. Found that female employees demonstrated a more positive regard for women in general, a less traditional view of women as managers, and a more positive perception of their communication competencies. (PD)

  3. Emotional competence and online game use in adolescents.

    PubMed

    Seo, Mia; Kang, Hee Sun; Chae, Sun-Mi

    2012-12-01

    The purpose of this study was to explore the relations between emotional competence and online game use in adolescents. This study is a cross-sectional descriptive survey using a convenience sample. The participants were 2199 adolescents in South Korea. Online game use and emotional competence including positive emotion, emotional expression, and emotional intelligence were measured. The study results indicated that emotional competence was negatively correlated with excessive online game use. All variables of emotional competence were significantly lower in high-risk users compared with general users. In addition, female adolescents were rated significantly higher in emotional competence among general users, but there were no significant gender differences among high-risk users. The results of our study imply that high-risk game users have lower levels of emotional intelligence than general users do. The results of this study suggest that emotion is an important factor to which practitioners in psychomedical fields and nursing should pay attention. Therefore, nurses in schools and communities should regularly screen the emotions of adolescents who habitually play online games and develop a program to enhance emotional competence associated with online games.

  4. An Initial Investigation of the Generalization of a School-Based Social Competence Intervention for Youth with High-Functioning Autism

    PubMed Central

    Schmidt, Carla; Stichter, Janine P.; Lierheimer, Kristin; McGhee, Stephanie; O'Connor, Karen V.

    2011-01-01

    This study evaluated the impact of generalization of the Social Competence Intervention-Adolescent (SCI-A) curriculum in a school setting for individuals with high-functioning autism or Asperger's Syndrome (N = 6). This study examined to what degree the generalization of the SCI-A curriculum could be measured when delivered in a school setting. Across the six participants preliminary results suggest improvement on teacher reports of social skills and executive functioning. Some improvements were also evident in direct measures of facial-expression recognition. Data collected in the nonintervention settings indicated that some generalization of social interaction skills may have occurred for all six participants. Future research directions are discussed. PMID:22937252

  5. Juvenile Competency to Stand Trial.

    PubMed

    Stepanyan, Sofia T; Sidhu, Shawn S; Bath, Eraka

    2016-01-01

    Competency to stand trial is interpreted as a protected due process right for all defendants and is defined as a defendant's fundamental knowledge and understanding of the criminal charges being filed, roles and procedures within the courtroom, and a general ability to work with the defense counsel. Questions of competency are most often raised by the judge, defense, or the prosecution, and competency evaluations are most often completed by psychiatrists or psychologists with forensic training or work experience. Mental illness, intellectual disability, developmental disorders, and developmental immaturity are the 4 main factors considered in most juvenile competency evaluations. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. 12 CFR 323.6 - Professional association membership; competency.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Professional association membership; competency... OF GENERAL POLICY APPRAISALS § 323.6 Professional association membership; competency. (a) Membership... membership or lack of membership in any particular appraisal organization. (b) Competency. All staff and fee...

  7. Competence for internship: perceptions of final-year medical students.

    PubMed

    Draper, C E; Louw, G J

    2012-07-01

    A 'new', problem-based medical curriculum was introduced at the University of Cape Town (UCT) in 2002. The objective of this study was to assess the perceptions of competence for internship and the factors influencing competence of final-year medical students. Eighteen focus groups were conducted (six per year) with UCT final-year medical students in 2007 (n =27), 2008 (n =27), and 2009 (n =30). Guide questions covered student's expectations of internship, perceptions of competence, priorities regarding competence, and factors influencing competence. Participants felt generally positive about and competent to enter internship, and the transition into internship was characterized as having both personal and professional components. Participants identified interpersonal skills, theoretical grounding, and intellectual ability as strengths, and lack of basic science knowledge and certain procedural skills as weaknesses. Factors influencing competence included personal initiative, motivation, and clinical exposure. Curriculum strengths identified were teaching of interpersonal skills and development of students as lifelong learners. The main weaknesses identified were teaching and assessment of basic sciences, and problem-based learning (PBL). Overall, the participants felt generally positive about internship and the 'new' curriculum, and felt generally competent to enter internship. Their responses highlight the role of confidence in the development of competence. These findings highlight the complexities surrounding perceptions of students about competence and views about the content and methodology of the learning. Perceptions of students regarding competence are an important indicator of the attainment of intended curriculum outcomes, and provide valuable information for the improvement of curriculum.

  8. 42 CFR 413.75 - Direct GME payments: General requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... physicians' salaries and fringe benefits attributable to direct graduate medical education (GME); and (2... publications: (i) The Directory of Graduate Medical Education Programs published by the American Medical... Council for Graduate Medical Education (ACGME) as a fellowship program in geriatric medicine. (4) Is a...

  9. 42 CFR 413.75 - Direct GME payments: General requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...-based providers for the costs of approved residency programs in medicine, osteopathy, dentistry, and... Council for Graduate Medical Education (ACGME) as a fellowship program in geriatric medicine. (4) Is a... Urban Consumers as compiled by the Bureau of Labor Statistics. Emergency Medicare GME affiliated group...

  10. 42 CFR 413.75 - Direct GME payments: General requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...-based providers for the costs of approved residency programs in medicine, osteopathy, dentistry, and... Council for Graduate Medical Education (ACGME) as a fellowship program in geriatric medicine. (4) Is a... Urban Consumers as compiled by the Bureau of Labor Statistics. Emergency Medicare GME affiliated group...

  11. 42 CFR 413.75 - Direct GME payments: General requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...-based providers for the costs of approved residency programs in medicine, osteopathy, dentistry, and... Council for Graduate Medical Education (ACGME) as a fellowship program in geriatric medicine. (4) Is a... Urban Consumers as compiled by the Bureau of Labor Statistics. Emergency Medicare GME affiliated group...

  12. A new competency model for general practice: implications for selection, training, and careers.

    PubMed

    Patterson, Fiona; Tavabie, Abdol; Denney, MeiLing; Kerrin, Máire; Ashworth, Vicki; Koczwara, Anna; MacLeod, Sheona

    2013-05-01

    Recent structural and policy changes in the UK health service have significantly changed the job responsibilities for the GP role. To replicate a previous job analysis study to examine the relevance of current competency domains and selection criteria for doctors entering training. A multisource, multimethod approach comprising three phases: (1) stakeholder consultation (n = 205) using interviews, focus groups and behavioural observation of practising GPs; (2) a validation questionnaire based on results from phase 1 (n = 1082); followed by (3) an expert panel (n = 6) to review and confirm the final competency domains. Eleven competency domains were identified, which extends previous research findings. A new domain was identified called Leading for Continuing Improvement. Results show that, Empathy and Perspective Taking, Communication Skills, Clinical Knowledge and Expertise, and Professional Integrity are currently rated the most important domains. Results indicate a significant increase in ratings of importance for each domain in the future (P<0.001), except for Communication Skills and Empathy and Perspective Taking, which consistently remain high. The breadth of competencies required for GPs has increased significantly. GPs are now required to resolve competing tensions to be effective in their role, such as maintaining a patient focus while overseeing commissioning, with a potential ethical conflict between these aspects. Selection criteria remain largely unchanged but with increased priority in some domains (for example, Effective Teamworking). However, there is an urgent need to review the training provision arrangements to reflect the greater breadth of competencies now required.

  13. Are Quantity Surveyors Competent to Value for Civil Engineering Works? Evaluating QSs' Competencies and Militating Factors

    ERIC Educational Resources Information Center

    Olawumi, Timothy Oluwatosin; Ayegun, Olaleke Amos

    2016-01-01

    The role of the quantity surveyor is one that is often unclear amongst the general public. This study discussed the competencies of the quantity surveyor in measuring and managing civil engineering works and also carrying out the financial management for civil engineering construction projects; also outlined the various competencies and skills…

  14. 29 CFR 1915.7 - Competent person.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 7 2013-07-01 2013-07-01 false Competent person. 1915.7 Section 1915.7 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) OCCUPATIONAL SAFETY AND HEALTH STANDARDS FOR SHIPYARD EMPLOYMENT General Provisions § 1915.7 Competent person...

  15. How to improve mental health competency in general practice training?--a SWOT analysis.

    PubMed

    van Marwijk, Harm

    2004-06-01

    It is quite evident there is room for improvement in the primary care management of common mental health problems. Patients respond positively when GPs adopt a more proactive role in this respect. The Dutch general practice curriculum is currently being renewed. The topics discussed here include the Strengths, Weaknesses, Opportunities and Threats (SWOT) of present primary mental healthcare teaching. What works well and what needs improving? Integrated teaching packages are needed to help general practice trainees manage various presentations of psychological distress. Such packages comprise training videotapes, in which models such as problem-solving treatment (PST) are demonstrated, as well as roleplaying material for new skills, self-report questionnaires for patients, and small-group video feedback of consultations. While GP trainees can effectively master such skills, it is important to query the level of proficiency required by registrars. Are these skills of use only to connoisseur GPs, or to all? More room for specialisation and differentiation among trainees may be the way forward. We have just developed a new curriculum for the obligatory three-month psychiatry housemanship. It is competency oriented, self-directed and assignment driven. This new curriculum will be evaluated in due course.

  16. Perceived Competence of Women Managers in Public Human Service Organizations: A Comparative View.

    ERIC Educational Resources Information Center

    Ezell, Hazel F.; And Others

    1980-01-01

    Responses of male and female managers were analyzed for differences existing in perceptions of self-competence and differences in their evaluations of the competence of women managers generally. Findings suggest female managers see themselves as competent but see female managers in general as being less competent. (Author/RC)

  17. Self-Assessment of competence during post-graduate training in general medicine: A preliminary study to develop a portfolio for further education.

    PubMed

    Huenges, Bert; Woestmann, Barbara; Ruff-Dietrich, Susanne; Rusche, Herbert

    2017-01-01

    Awareness of one's own strengths and weaknesses is a key qualification for the specialist physician. We examined how physicians undergoing specialist training in general medicine rate themselves in different areas. For this purpose, 139 participants receiving post-graduate training in general practice offered by the Medical Association of Westfalen-Lippe assessed themselves regarding their subjective confidence in 20 core competencies and 47 situations involving patient counseling in general practice. Their self-assessments were recorded on a five-point Likert scale. The study questions addressed acceptance and practicability of self-assessment, mean values, reliability, stratification and plausibility of the results in group comparison. On average participants rated their subjective confidence with 3.4 out of 5 points. The results are self-consistent (Cronbach's alpha >0.8), although there are considerable differences among competencies and among participants. The latter can be explained partly by biographical data, which supports the plausibility of the data. Participants stated that regularly gathering data on subjective learning needs and the discussion of these needs with mentors and trainers contributes to improving their specialist training. Elements for self-assessment are suitable for integration into a postgraduate training portfolio. These should be supplemented by formative assessment procedures.

  18. A model for a career in a specialty of general surgery: One surgeon's opinion.

    PubMed

    Ko, Bona; McHenry, Christopher R

    2018-01-01

    The integration of general and endocrine surgery was studied as a potential career model for fellowship trained general surgeons. Case logs collected from 1991-2016 and academic milestones were examined for a single general surgeon with a focused interest in endocrine surgery. Operations were categorized using CPT codes and the 2017 ACGME "Major Case Categories" and there frequencies were determined. 10,324 operations were performed on 8209 patients. 412.9 ± 84.9 operations were performed yearly including 279.3 ± 42.7 general and 133.7 ± 65.5 endocrine operations. A high-volume endocrine surgery practice and a rank of tenured professor were achieved by years 11 and 13, respectively. At year 25, the frequency of endocrine operations exceeded general surgery operations. Maintaining a foundation in broad-based general surgery with a specialty focus is a sustainable career model. Residents and fellows can use the model to help plan their careers with realistic expectations. Copyright © 2017. Published by Elsevier Inc.

  19. 42 CFR 493.1235 - Standard: Personnel competency assessment policies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Standard: Personnel competency assessment policies... Nonwaived Testing General Laboratory Systems § 493.1235 Standard: Personnel competency assessment policies... written policies and procedures to assess employee and, if applicable, consultant competency. ...

  20. Resident performance on the in-training and board examinations in obstetrics and gynecology: implications for the ACGME Outcome Project.

    PubMed

    Withiam-Leitch, Matthew; Olawaiye, Alexander

    2008-01-01

    The Accreditation Council on Graduate Medical Education (ACGME) Outcomes Project has endorsed the in-training examination (ITE) as an example of a multiple-choice question examination that is a valid measure of a resident's attainment of medical knowledge. An outcome measure for performance on the ITE would be the subsequent performance on the board certification examination. However, there are few reports that attempt to correlate a resident's performance on the ITE to subsequent performance on the board certification examination. The Council on Resident Education in Obstetrics and Gynecology (CREOG) has administered the ITE annually since 1970. This study tested the hypothesis that the CREOG-ITE score is a valid assessment tool to predict performance on the American Board of Obstetrics and Gynecology (ABOG) written examination. CREOG-ITE and ABOG written board examination results were collected for 69 resident graduates between the years 1998 and 2005. Logistic regression and receiver operating characteristic analyses were used to estimate the relationship between a resident's score on the CREOG-ITE and subsequent performance on the ABOG written examination. Fifty-seven resident graduates passed (82.6%) and 12 graduates failed (17.4%) the ABOG written examination. The correlation between the CREOG-ITE overall score and performance on the ABOG examination was weak (correlation coefficient =.38, p =.001). Receiver operating characteristic analysis for the CREOG-ITE overall scores and the probability of passing or failing the ABOG examination revealed moderate accuracy (area under the curve = 0.77, 95% CI = 0.62-0.92) with a CREOG-ITE score of 187.5 yielding the best trade-off between specificity (0.79) and sensitivity (0.75). At the cutoff value of 187.5 there was a weak positive predictive value of 43% (i.e., 43% of residents with a score less than 187.5 will fail the ABOG exam) and a strong negative predictive value of 94% (i.e., 94% of the residents with a score

  1. The contribution of the therapist's competence in the treatment of adolescents with generalized social phobia.

    PubMed

    Olivares, José; Olivares-Olivares, Pablo J; Rosa-Alcázar, Ana I; Montesinos, Luis; Macià, Diego

    2014-01-01

    The purpose of this study was to explore which of the outcomes attained by the application of the psychological program Intervención en Adolescentes con Fobia Social (Intervention in Adolescents with Social Phobia) can be attributed to the therapist's competence. The experimental study consists of three conditions: Waiting list control, Group treated by expert psychologists, and Group treated by inexperienced psychologists, with a sample of 110 Spanish adolescents whose mean age was 15.42 years (SD = 0.97, range: 14-18). All participants met the criteria for diagnosis of Generalized Social Phobia) and most of them were female (65.45%). (i) The effect size attributable to the therapist was low compared to the effect size associated with the manual-based treatment program in the dependent variables measured, and (ii) Expert therapists attained a much greater remission of the criteria for the diagnosis of Generalized Social Phobia among participants than did the inexperienced therapists. The IAFS Program was responsible for most of the change measured in participants.

  2. The general surgery chief resident operative experience: 23 years of national ACGME case logs.

    PubMed

    Drake, Frederick Thurston; Horvath, Karen D; Goldin, Adam B; Gow, Kenneth W

    2013-09-01

    The chief resident (CR) year is a pivotal experience in surgical training. Changes in case volume and diversity may impact the educational quality of this important year. To evaluate changes in operative experience for general surgery CRs. Review of Accreditation Council for Graduate Medical Education case logs from 1989-1990 through 2011-2012 divided into 5 periods. Graduates in period 3 were the last to train with unrestricted work hours; those in period 4 were part of a transition period and trained under both systems; and those in period 5 trained fully under the 80-hour work week. Diversity of cases was assessed based on Accreditation Council for Graduate Medical Education defined categories. Total cases and defined categories were evaluated for changes over time. The average total CR case numbers have fallen (271 in period 1 vs 242 in period 5, P < .001). Total CR cases dropped to their lowest following implementation of the 80-hour work week (236 cases), but rebounded in period 5. The percentage of residents' 5-year operative experience performed as CRs has decreased (30% in period 1 vs 25.6% in period 5, P < .001). Regarding case mix: thoracic, trauma, and vascular cases declined steadily, while alimentary and intra-abdominal operations increased. Recent graduates averaged 80 alimentary and 78 intra-abdominal procedures during their CR years. Compared with period 1, in which these 2 categories represented 47.1% of CR experience, in period 5, they represented 65.2% (P < .001). Endocrine experience has been relatively unchanged. Total CR cases declined especially acutely following implementation of the 80-hour work week but have since rebounded. Chief resident cases contribute less to overall experience, although this proportion stabilized before the 80-hour work week. Case mix has narrowed, with significant increases in alimentary and intra-abdominal cases. Broad-based general surgery training may be jeopardized by reduced case diversity. Chief

  3. Developing a Practice-Based Learning and Improvement Curriculum for an Academic General Surgery Residency

    PubMed Central

    O'Connor, Erin S.; Mahvi, David M.; Foley, Eugene F.; Lund, Dennis; McDonald, Robert

    2010-01-01

    Background Program Directors in Surgery are now facing the challenge of incorporating the ACGME's practice-based learning and improvement (PBLI) competency into residency curriculum. We introduced a comprehensive PBLI experience for PG2 residents designed to integrate specific competency goals (quality improvement, clinical thinking, and self-directed learning) within the context of residents’ clinical practice. Study Design Fourteen PG2 residents participated in a three-week PBLI curriculum consisting of three components: Complex Clinical Decision Making (CCDM), Individual Learning Plan, and Quality Improvement (QI). To assess how effectively the curriculum addressed these three competencies, residents rated their understanding of PBLI by answering a 12-question written survey given pre- and post-rotation. Resident satisfaction was assessed through standard post-rotation evaluations. Results Analysis of the pre and post rotation surveys from the fourteen participants showed an increase in all measured elements, including knowledge of PBLI (p<0.001), ability to assess learning needs (p<0.001) and set learning goals (p<0.001), understanding of QI concepts (p=0.001), and experience with QI projects (p<0.001). Fourteen QI projects were developed. Although many residents found the creation of measurable learning goals to be challenging, the process of identifying strengths and weaknesses enhanced the resident's self-understanding, and contributed to overall satisfaction with the rotation. Conclusions The initial implementation of our PBLI curriculum demonstrated that residents report personal progress in their clinical decision making, self-directed learning, and familiarity with quality improvement. This comprehensive PBLI curriculum was accepted by surgical residents as a valuable part of their training. We are encouraged to continue a clinically-grounded PBLI experience for PG2 residents. PMID:20347732

  4. 5 CFR 531.409 - Acceptable level of competence determinations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Acceptable level of competence... REGULATIONS PAY UNDER THE GENERAL SCHEDULE Within-Grade Increases § 531.409 Acceptable level of competence... delegated shall determine which employees are performing at an acceptable level of competence. (b) Basis for...

  5. Vascular Trauma Operative Experience is Inadequate in General Surgery Programs.

    PubMed

    Yan, Huan; Maximus, Steven; Koopmann, Matthew; Keeley, Jessica; Smith, Brian; Virgilio, Christian de; Kim, Dennis Y

    2016-05-01

    Vascular injuries may be challenging, particularly for surgeons who have not received formal vascular surgery fellowship training. Lack of experience and improper technique can result in significant complications. The objective of this study was to examine changes in resident experience with operative vascular trauma over time. A retrospective review was performed using Accreditation Council for Graduate Medical Education (ACGME) case logs of general surgery residents graduating between 2004 and 2014 at 2 academic, university-affiliated institutions associated with level 1 trauma centers. The primary outcome was number of reported vascular trauma operations, stratified by year of graduation and institution. A total of 112 residents graduated in the study period with a median 7 (interquartile range 4.5-13.5) vascular trauma cases per resident. Fasciotomy and exposure and/or repair of peripheral vessels constituted the bulk of the operative volume. Linear regression showed no significant trend in cases with respect to year of graduation (P = 0.266). Residents from program A (n = 53) reported a significantly higher number of vascular trauma cases when compared with program B (n = 59): 12.0 vs. 5.0 cases, respectively (P < 0.001). Level 1 trauma center verification does not guarantee sufficient exposure to vascular trauma. The operative exposure in program B is reflective of the national average of 4.0 cases per resident as reported by the ACGME, and this trend is unlikely to change in the near future. Fellowship training may be critical for surgeons who plan to work in a trauma setting, particularly in areas lacking vascular surgeons. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. National trends in otolaryngology intern curricula following Accreditation Council for Graduate Medical Education changes.

    PubMed

    Kovatch, Kevin J; Harvey, Rebecca S; Prince, Mark E P; Thorne, Marc C

    2017-10-09

    In 2016, Accreditation Council for Graduate Medical Education (ACGME) requirements for curriculum and resident experiences were modified to require entering postgraduate year (PGY)-1 residents to spend 6 months of structured education on otolaryngology-head and neck surgery (ORL-HNS) rotations. We aimed to determine how ORL-HNS training programs have adapted curricula in response to 2016 ACGME curriculum requirement changes. Survey study. A national survey of ACGME-accredited ORL-HNS programs was distributed via the Otolaryngology Program Directors Organization. Thirty-seven program directors responded (34.9%). Most common ORL-HNS rotations included general otolaryngology (80.6% of programs, up to 6 months) and head and neck oncology (67.7%, up to 4 months), though more months are also spent on other subspecialty rotations (laryngology, otology, rhinology, and pediatrics) than previously. All programs continue at least 1 month of anesthesiology, intensive care unit, and general surgery. Programs have preferentially eliminated rotations in emergency medicine (77% decrease) and additional months on general surgery (48% decrease). Curricula have incorporated supplemental teaching modalities including didactic lectures (96.3% of programs), simulation (66.7%), dissection courses (63.0%), and observed patient encounters (55.5%), to a greater degree following ACGME changes. More interns are involved in shared call responsibilities than in previous years (70.4% vs. 51.8%). A stable minority of interns take the Otolaryngology Training Examination (approximately 20%). New ACGME requirements have challenged ORL-HNS training programs to develop effective 6-month rotation schedules for PGY-1 residents. Significant variation exists between programs, and evaluation of first-year curricula and readiness for PGY-2 year is warranted. NA Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  7. Customizing a clinical data warehouse for housestaff education in practice-based learning and improvement.

    PubMed

    Lyman, J; Schorling, J; May, N; Scully, K; Sarafian, N; Nadkarni, M; Voss, J

    2006-01-01

    We developed Systems and Practice Analysis for Resident Competencies (SPARC), a Web-based tool to support teaching the practice-based learning and improvement (PBLI) ACGME competencies. SPARC allows Department of Medicine residents to explore de-identified, population-based data about their patient panels with peer comparisons. Data primarily comes from an existing data warehouse that has been customized for this application. Our preliminary evaluation suggests that it improves residents' abilities in PBLI, is easy to use, and perceived as important and useful by the housestaff.

  8. Self-Assessment of competence during post-graduate training in general medicine: A preliminary study to develop a portfolio for further education

    PubMed Central

    Huenges, Bert; Woestmann, Barbara; Ruff-Dietrich, Susanne; Rusche, Herbert

    2017-01-01

    Awareness of one’s own strengths and weaknesses is a key qualification for the specialist physician. We examined how physicians undergoing specialist training in general medicine rate themselves in different areas. For this purpose, 139 participants receiving post-graduate training in general practice offered by the Medical Association of Westfalen-Lippe assessed themselves regarding their subjective confidence in 20 core competencies and 47 situations involving patient counseling in general practice. Their self-assessments were recorded on a five-point Likert scale. The study questions addressed acceptance and practicability of self-assessment, mean values, reliability, stratification and plausibility of the results in group comparison. On average participants rated their subjective confidence with 3.4 out of 5 points. The results are self-consistent (Cronbach’s alpha >0.8), although there are considerable differences among competencies and among participants. The latter can be explained partly by biographical data, which supports the plausibility of the data. Participants stated that regularly gathering data on subjective learning needs and the discussion of these needs with mentors and trainers contributes to improving their specialist training. Elements for self-assessment are suitable for integration into a postgraduate training portfolio. These should be supplemented by formative assessment procedures. PMID:29226236

  9. Training Internists to Meet Critical Care Needs in the United States: A Consensus Statement from the Critical Care Societies Collaborative (CCSC)

    PubMed Central

    Pastores, Stephen M.; Martin, Greg S.; Baumann, Michael H.; Curtis, J. Randall; Farmer, J. Christopher; Fessler, Henry E.; Gupta, Rakesh; Hill, Nicholas S.; Hyzy, Robert C.; Kvetan, Vladimir; MacGregor, Drew A.; O’Grady, Naomi P.; Ognibene, Frederick P.; Rubenfeld, Gordon D.; Sessler, Curtis N.; Siegal, Eric; Simpson, Steven Q.; Spevetz, Antoinette; Ward, Nicholas S.; Zimmerman, Janice L.

    2014-01-01

    Objectives Multiple training pathways are recognized by the Accreditation Council for Graduate Medical Education (ACGME) for internal medicine (IM) physicians to certify in critical care medicine (CCM) via the American Board of Internal Medicine. While each involves 1 year of clinical fellowship training in CCM, substantive differences in training requirements exist among the various pathways. The Critical Care Societies Collaborative convened a task force to review these CCM pathways and to provide recommendations for unified and coordinated training requirements for IM-based physicians. Participants A group of CCM professionals certified in pulmonary-CCM and/or IM-CCM from ACGME-accredited training programs who have expertise in education, administration, research, and clinical practice. Data Sources and Synthesis Relevant published literature was accessed through a MEDLINE search and references provided by all task force members. Material published by the ACGME, American Board of Internal Medicine, and other specialty organizations was also reviewed. Collaboratively and iteratively, the task force reached consensus using a roundtable meeting, electronic mail, and conference calls. Main Results Internal medicine-CCM–based fellowships have disparate program requirements compared to other internal medicine subspecialties and adult CCM fellowships. Differences between IM-CCM and pulmonary-CCM programs include the ratio of key clinical faculty to fellows and a requirement to perform 50 therapeutic bronchoscopies. Competency-based training was considered uniformly desirable for all CCM training pathways. Conclusions The task force concluded that requesting competency-based training and minimizing variations in the requirements for IM-based CCM fellowship programs will facilitate effective CCM training for both programs and trainees. PMID:24637881

  10. Milestones: Critical Elements in Clinical Informatics Fellowship Programs

    PubMed Central

    Lehmann, Christoph U.; Munger, Benson

    2016-01-01

    Summary Background Milestones refer to points along a continuum of a competency from novice to expert. Resident and fellow assessment and program evaluation processes adopted by the ACGME include the mandate that programs report the educational progress of residents and fellows twice annually utilizing Milestones developed by a specialty specific ACGME working group of experts. Milestones in clinical training programs are largely unmapped to specific assessment tools. Residents and fellows are mainly assessed using locally derived assessment instruments. These assessments are then reviewed by the Clinical Competency Committee which assigns and reports trainee ratings using the specialty specific reporting Milestones. Methods and Results The challenge and opportunity facing the nascent specialty of Clinical Informatics is how to optimally utilize this framework across a growing number of accredited fellowships. The authors review how a mapped milestone framework, in which each required sub-competency is mapped to a single milestone assessment grid, can enable the use of milestones for multiple uses including individualized learning plans, fellow assessments, and program evaluation. Furthermore, such a mapped strategy will foster the ability to compare fellow progress within and between Clinical Informatics Fellowships in a structured and reliable fashion. Clinical Informatics currently has far less variability across programs and thus could easily utilize a more tightly defined set of milestones with a clear mapping to sub-competencies. This approach would enable greater standardization of assessment instruments and processes across programs while allowing for variability in how those sub-competencies are taught. Conclusions A mapped strategy for Milestones offers significant advantages for Clinical Informatics programs. PMID:27081414

  11. The development and validation of the Perceived Health Competence Scale.

    PubMed

    Smith, M S; Wallston, K A; Smith, C A

    1995-03-01

    A sense of competence or self-efficacy is associated with many positive outcomes, particularly in the area of health behavior. A measure of a sense of competence in the domain of health behavior has not been developed. Most measures are either general measures of a general sense of self-efficacy or are very specific to a particular health behavior. The Perceived Health Competence Scale (PHCS), a domain-specific measure of the degree to which an individual feels capable of effectively managing his or her health outcomes, was developed to provide a measure of perceived competence at an intermediate level of specificity. Five studies using three different types of samples (students, adults and persons with a chronic illness) provide evidence for the reliability and validity of the PHCS. The eight items of the PHCS combine both outcome and behavioral expectancies. Results from the five studies indicate that the scale has good internal consistency and test-retest reliability. The construct validity of the scale is demonstrated through the support obtained for substantive hypotheses regarding the correlates of perceived health competence, such as health behavior intentions, general sense of competence and health locus of control.

  12. Leadership Training and the Problems of Competency Development.

    PubMed

    Reid, W Michael; Dold, Claudia Jennifer

    An important workforce development effort during the past 25 years has been developing competency sets. Several of the sets rely on the concepts of Senge's Learning Organization and Burns' Transformational Leadership. The authors' experiences and study in designing and implementing a curriculum for a public health leadership institute based on these concepts raised several important questions about competency development and application. To summarize the use of the Senge and Burns frameworks in several competency sets and the practice literature and to assess the status of competency development for those frameworks and for competency development generally. The authors reviewed several commonly used competency sets and textbooks and searched 3 leading public health practice journals (Journal of Public Health Management and Practice, Public Health Reports, and American Journal of Public Health) for Senge and Burns framework terms. They also reviewed efforts to implement competency sets in public health education and practice. (1) The extent to which the articles and texts demonstrated understanding of the frameworks and reported their implementation and (2) whether competency statements and their uses in the literature contained precise definitions of competencies (knowledge, skills, behaviors, and attitudes associated with them), the standards by which competence is to be measured, and the means for measuring their attainment. "Learning Organization" and "Transformational Leadership" terms were used often and viewed favorably. However, the terms were rarely defined as Senge and Burns had, the uses generally did not indicate the complexity and difficulty of implementation, and there was only one report of even partial implementation. The review of competency development efforts found there is virtually no attention to the definitional and measurement issues in the literature. Unless public health organizations recognize the need for a common understanding of

  13. Natural Resources. Ohio's Competency Analysis Profile. Forest Industry Worker. Resource Conservation.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Vocational Instructional Materials Lab.

    This competency analysis profile lists 155 competencies that have been identified by employers as core competencies for inclusion in programs to train forest industry and resource conservation workers. The core competencies are organized into 10 units dealing the following: general safety precautions, natural resource industry operations, soil…

  14. Developing a comprehensive resident education evaluation system in the era of milestone assessment.

    PubMed

    Gardner, Aimee K; Scott, Daniel J; Choti, Michael A; Mansour, John C

    2015-01-01

    In an effort to move training programs toward competency-based education, the Accreditation Council for Graduate Medical Education (ACGME) introduced the Next Accreditation System (NAS), which organizes specific milestones regarding resident skills, knowledge, and abilities along a continuum. In order to foster innovation and creativity, the ACGME has provided programs with minimal guidelines regarding the optimal way to approach these milestones. The education team at UT Southwestern embraced the milestones and developed a process in which performance assessment methods were critically evaluated, mapped onto an extrapolated performance list corresponding to the areas required by the ACGME milestones, and filled gaps in the previous system by modifying evaluation tools and creating new program components. Although the authors are early in the evolution of applying the new milestones system, this approach has thus far allowed them to comprehensively evaluate the residents and the program in an efficient and effective fashion, with notable improvements compared to the prior approach. The authors hope that these experiences can inform others embarking upon similar journeys with the milestones. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  15. Enhancing the Value of Expert Assistance in Pro Se Competence Determinations.

    PubMed

    Fitch, W Lawrence

    2016-12-01

    Forensic mental health practitioners are comfortable assessing criminal defendants' competence to stand trial. They have a long history of making such assessments and a large body of research and scholarship to guide them. In recent years, however, the courts have drawn a distinction between general trial competence (i.e., competence while represented by counsel) and competence to proceed pro se (i.e., competence without counsel). The seminal case on point is Indiana v. Edwards (554 U.S. 164 (2008)). In Edwards, the Court found that general trial competence may provide an inadequate measure of pro se competence. Recognizing the profession's need for direction in making the more particularized assessment called for in pro se cases, White and Gutheil offer a new "Model for Assessing Defendant Competence to Self-Represent." Neatly tied to the elements of pro se competence, discussed in Edwards, and envisioning a fresh new role for experts, consistent with the Court's reasoning, the model provides a valuable resource for forensic practitioners. © 2016 American Academy of Psychiatry and the Law.

  16. 48 CFR 19.601 - General.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... BUSINESS PROGRAMS Certificates of Competency and Determinations of Responsibility 19.601 General. (a) A Certificate of Competency (COC) is the certificate issued by the Small Business Administration (SBA) stating... limited to, capability, competency, capacity, credit, integrity, perseverance, tenacity, and limitations...

  17. Customizing a Clinical Data Warehouse for Housestaff Education in Practice-Based Learning and Improvement

    PubMed Central

    Lyman, J; Schorling, J; May, N; Scully, K; Sarafian, N; Nadkarni, M; Voss, J

    2006-01-01

    We developed Systems and Practice Analysis for Resident Competencies (SPARC), a Web-based tool to support teaching the practice-based learning and improvement (PBLI) ACGME competencies. SPARC allows Department of Medicine residents to explore de-identified, population-based data about their patient panels with peer comparisons. Data primarily comes from an existing data warehouse that has been customized for this application. Our preliminary evaluation suggests that it improves residents' abilities in PBLI, is easy to use, and is perceived as important and useful by the housestaff. PMID:17238636

  18. Competing Activation during Fantasy Text Comprehension

    ERIC Educational Resources Information Center

    Creer, Sarah D.; Cook, Anne E.; O'Brien, Edward J.

    2018-01-01

    During comprehension, readers' general world knowledge and contextual information compete for influence during integration and validation. Fantasy narratives, in which general world knowledge often conflicts with fantastical events, provide a setting to examine this competition. Experiment 1 showed that with sufficient elaboration, contextual…

  19. The Action Competence Approach in Environmental Education

    ERIC Educational Resources Information Center

    Jensen, Bjarne Bruun; Schnack, Karsten

    2006-01-01

    In this article, the concept of action competence is presented and an attempt is made to locate it within the concept of general educational theory. The concept of action competence, it is argued, should occupy a central position in the theory of environmental education as many of the crucial educational problems concerning a political liberal…

  20. Developing a practice-based learning and improvement curriculum for an academic general surgery residency.

    PubMed

    O'Connor, Erin S; Mahvi, David M; Foley, Eugene F; Lund, Dennis; McDonald, Robert

    2010-04-01

    Program directors in surgery are now facing the challenge of incorporating the ACGME's practice-based learning and improvement (PBLI) competency into residency curriculum. We introduced a comprehensive PBLI experience for postgraduate year 2 (PGY2) residents designed to integrate specific competency goals (ie, quality improvement, clinical thinking, and self-directed learning) within the context of residents' clinical practice. Fourteen PGY2 residents participated in a 3-week PBLI curriculum consisting of 3 components: complex clinical decision making, individual learning plan, and quality improvement (QI). To assess how effectively the curriculum addressed these 3 competencies, residents rated their understanding of PBLI by answering a 12-question written survey given pre- and post-rotation. Resident satisfaction was assessed through standard post-rotation evaluations. Analysis of the pre- and post-rotation surveys from the 14 participants showed an increase in all measured elements, including knowledge of PBLI (p < 0.001), ability to assess learning needs (p < 0.001), set learning goals (p < 0.001), understanding of QI concepts (p = 0.001), and experience with QI projects (p < 0.001). Fourteen QI projects were developed. Although many residents found the creation of measurable learning goals to be challenging, the process of identifying strengths and weaknesses enhanced the resident's self-understanding and contributed to overall satisfaction with the rotation. The initial implementation of our PBLI curriculum demonstrated that residents report personal progress in their clinical decision making, self-directed learning, and familiarity with QI. This comprehensive PBLI curriculum was accepted by surgical residents as a valuable part of their training. We are encouraged to continue a clinically grounded PBLI experience for PGY2 residents. Copyright (c) 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Competency Based Assessment in Fashion Design

    NASA Astrophysics Data System (ADS)

    Russanti, Irma; Nurlaela, Lutfiyah; Basuki, Ismet; Munoto

    2018-04-01

    Professional certification is a form of stipulation on certain competency standards provided by one professional organization to the performance of a person through assessment. For that an assessment needs to be standardized so that there exists a general standardized scale to measure competence. In the professional certification of fashion design department, an instrument of competency based assessment is essential to be developed. The purpose of this review is to know the application of competency based assessment in the field of fashion design. The literature reviews were found by journal searching with keywords competency based assessment and fashion design in Google scholar, of which was gotten over 20 journals from 2006 to 2016. Afterwards, the search of the free-downloaded e-books in libgen was conducted under competency based assessment and fashion design, which is then found some related references. The obtained literatures were used to review the definition, approach, and implementation of competency based assessment in the field of fashion design. Results show that it is important to develop an assessment sheet in the field of fashion design covering garment, apparel and embroidery sectors by patterning the criteria of performers along with the qualifications.

  2. Nurse leaders and the innovation competence gap.

    PubMed

    White, Kenneth R; Pillay, Rubin; Huang, Xuan

    2016-01-01

    Nurses are well-positioned for innovation in health care delivery, although innovation is not generally learned in formal educational programs. The purpose of this study was to assess critical competencies for innovation success among nurse leaders in academia and practice, the perceived gaps on those competencies, and teaching methods that would be helpful in developing competencies related to innovation. A Web-enabled descriptive survey design was used to capture nurse leaders' perceptions of important innovation competencies and how they assess their level of competence in the particular innovation domain. Preferred approaches for innovation pedagogy were also queried. Respondents indicated significant gaps in 18 of 19 innovation competencies. Implications are for inclusion of innovation competencies in formal and continuing nursing education. The most preferred innovation pedagogical approaches are case studies of failures and successes and project- and field-based approaches. Traditional lectures are the least preferred way to address innovation competency gaps. There is a significant gap in innovation competencies among nurse leaders in practice and academia. The way we teach innovation needs to involve closer collaboration between academia and practice. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Improving ECG Competence in Medical Trainees in a UK District General Hospital

    PubMed Central

    McAloon, Christopher; Leach, Helen; Gill, Simrat; Aluwalia, Arun; Trevelyan, Jasper

    2014-01-01

    Background Competency in electrocardiogram (ECG) interpretation is central to undergraduate and postgraduate clinical training. Studies have demonstrated ECGs are interpreted sub-optimally. Our study compares the effectiveness of two learning strategies to improve competence and confidence. Method A 1-month prospective randomized study compared the strategies in two cohorts: undergraduate third year medical students and postgraduate foundation year one (FY1) doctors. Both had blinded randomization to one of these learning strategies: focused teaching program (FTP) and self-directed learning (SDL). All volunteers completed a confidence questionnaire before and after allocation learning strategy and an ECG recognition multiple choice question (MCQ) paper at the end of the learning period. Results The FTP group of undergraduates demonstrated a significant difference in successfully interpreting “ventricular tachycardia” (P = 0.046) and “narrow complex tachycardia” (P = 0.009) than the SDL group. Participant confidence increased in both learning strategies. FTP confidence demonstrated a greater improvement than SDL for both cohorts. Conclusion A dedicated teaching program can improve trainee confidence and competence in ECG interpretation. A larger benefit is observed in undergraduates and those undertaking a FTP. PMID:28392875

  4. Effect of the 80-hour work week on cases performed by general surgery residents.

    PubMed

    McElearney, Shannon Tierney; Saalwachter, Alison R; Hedrick, Traci L; Pruett, Timothy L; Sanfey, Hilary A; Sawyer, Robert G

    2005-07-01

    The Accreditation Council for Graduate Medical Education (ACGME) implemented mandatory work week hours restrictions in 2003. Due to the traditionally long hours in general surgery, the effect of restrictions on surgical training and case numbers was a matter of concern. Data was compiled retrospectively from ACGME logs and operating room (OR) records at a university hospital for 2002 and 2003. Work week restrictions began in January 2003. This data was reviewed to determine resident case numbers, both in whole and by postgraduate year (PGY). Mean case numbers per resident-month in 2002 were 8.8 +/- 8.2 for PGY1s, 16.2 +/- 15.7 for PGY2s, 31.4 +/- 12.9 for PGY3s, 31.5 +/- 17.6 for PGY4s, and 31.5 +/- 17.6 for PGY5s. In 2003, they were 8.8 +/- 5.2 for PGY1s, 16.6 +/- 13.9 for PGY2s, 27.8 +/- 12.5 for PGY3s, 38.2 +/- 18.8 for PGY4s, and 26.1 +/- 9.6 for PGY5s. PGY1s, PGY2s, PGY3s, PGY4s, or all classes were not statistically different. PGY5s did have statistically fewer cases in 2003 (P = 0.03). PGY5s did have statistically fewer cases after the work-hours restriction, which likely represented shifting of postcall afternoon cases to other residents. Comparing other classes and all PGYs, case numbers were not statistically different. Operative training experience does not appear to be hindered by the 80-hour work week.

  5. Questionnaire-based evaluation of everyday competence in older adults.

    PubMed

    Kalisch, Tobias; Richter, Julia; Lenz, Melanie; Kattenstroth, Jan-Christoph; Kolankowska, Izabela; Tegenthoff, Martin; Dinse, Hubert R

    2011-01-01

    Gerontological research aims at understanding factors that are crucial for mediating "successful aging". This term denotes the absence of significant disease and disabilities, maintenance of high levels of physical and cognitive function, and preservation of social and productive activities. Preservation of an active lifestyle is considered an effective means through which everyday competence can be attained. In this context, it is crucial to obtain ratings of modern day older adults' everyday competence by means of appropriate assessments. Here, we introduce the Everyday Competence Questionnaire (ECQ), designed to assess healthy older adults' everyday competence. The ECQ includes 17 items, covering housekeeping, leisure activities, sports, daily routines, manual skills, subjective well-being, and general linguistic usage. The ECQ was administered to a population of 158 healthy subjects aged 60-91 years, who were divided into groups on the basis of their physical activity. These groups were community-dwelling subjects, those living independently and having a sedentary lifestyle, those living independently but characterized by a general lifestyle without any noteworthy physical activity, and those living independently and exercising regularly. Age, gender, and education levels were balanced between the groups. Using the ECQ, we could identify and distinguish different everyday competence levels between the groups tested: Subjects characterized by an active lifestyle outperformed all other groups. Subjects characterized by a general lifestyle showed higher everyday competence than those with a sedentary lifestyle or subjects who needed care. Furthermore, the ECQ data showed a significant positive correlation between individual physical activity and everyday competence. The ECQ is a novel tool for the questionnaire-based evaluation of everyday competence among healthy subjects. By including leisure activities, it considers the changed living conditions of modern

  6. Assessing medical students' performance in core competencies using multiple admission programs for colleges and universities: from the perspective of multi-source feedback.

    PubMed

    Fang, Ji-Tseng; Ko, Yu-Shien; Chien, Chu-Chun; Yu, Kuang-Hui

    2013-01-01

    Since 1994, Taiwanese medical universities have employed the multiple application method comprising "recommendations and screening" and "admission application." The purpose of this study is to examine whether medical students admitted using different admission programs gave different performances. To evaluate the six core competencies for medical students proposed by Accreditation Council for Graduate Medical Education (ACGME), this study employed various assessment tools, including student opinion feedback, multi-source feedback (MSF), course grades, and examination results.MSF contains self-assessment scale, peer assessment scale, nursing staff assessment scale, visiting staff assessment scale, and chief resident assessment scale. In the subscales, the CronbachÊs alpha were higher than 0.90, indicating good reliability. Research participants consisted of 182 students from the School of Medicine at Chang Gung University. Regarding studentsÊ average grade for the medical ethics course, the performance of students who were enrolled through school recommendations exceeded that of students who were enrolled through the National College University Entrance Examination (NCUEE) p = 0.011), and all considered "teamwork" as the most important. Different entry pipelines of students in the "communication," "work attitude," "medical knowledge," and "teamwork" assessment scales showed no significant difference. The improvement rate of the students who were enrolled through the school recommendations was better than that of the students who were enrolled through the N CUEE in the "professional skills," "medical core competencies," "communication," and "teamwork" projects of self-assessment and peer assessment scales. However, the students who were enrolled through the NCUEE were better in the "professional skills," "medical core competencies," "communication," and "teamwork" projects of the visiting staff assessment scale and the chief resident assessment scale. Collectively

  7. Visuospatial Aptitude Testing Differentially Predicts Simulated Surgical Skill.

    PubMed

    Hinchcliff, Emily; Green, Isabel; Destephano, Christopher; Cox, Mary; Smink, Douglas; Kumar, Amanika; Hokenstad, Erik; Bengtson, Joan; Cohen, Sarah

    2018-02-05

    To determine if visuospatial perception (VSP) testing is correlated to simulated or intraoperative surgical performance as rated by the American College of Graduate Medical Education (ACGME) milestones. Classification II-2 SETTING: Two academic training institutions PARTICIPANTS: 41 residents, including 19 Brigham and Women's Hospital and 22 Mayo Clinic residents from three different specialties (OBGYN, general surgery, urology). Participants underwent three different tests: visuospatial perception testing (VSP), Fundamentals of Laparoscopic Surgery (FLS®) peg transfer, and DaVinci robotic simulation peg transfer. Surgical grading from the ACGME milestones tool was obtained for each participant. Demographic and subject background information was also collected including specialty, year of training, prior experience with simulated skills, and surgical interest. Standard statistical analysis using Student's t test were performed, and correlations were determined using adjusted linear regression models. In univariate analysis, BWH and Mayo training programs differed in both times and overall scores for both FLS® peg transfer and DaVinci robotic simulation peg transfer (p<0.05 for all). Additionally, type of residency training impacted time and overall score on robotic peg transfer. Familiarity with tasks correlated with higher score and faster task completion (p= 0.05 for all except VSP score). There was no difference in VSP scores by program, specialty, or year of training. In adjusted linear regression modeling, VSP testing was correlated only to robotic peg transfer skills (average time p=0.006, overall score p=0.001). Milestones did not correlate to either VSP or surgical simulation testing. VSP score was correlated with robotic simulation skills but not with FLS skills or ACGME milestones. This suggests that the ability of VSP score to predict competence differs between tasks. Therefore, further investigation is required into aptitude testing, especially prior

  8. Nursing competency standards in primary health care: an integrative review.

    PubMed

    Halcomb, Elizabeth; Stephens, Moira; Bryce, Julianne; Foley, Elizabeth; Ashley, Christine

    2016-05-01

    This paper reports an integrative review of the literature on nursing competency standards for nurses working in primary health care and, in particular, general practice. Internationally, there is growing emphasis on building a strong primary health care nursing workforce to meet the challenges of rising chronic and complex disease. However, there has been limited emphasis on examining the nursing workforce in this setting. Integrative review. A comprehensive search of relevant electronic databases using keywords (e.g. 'competencies', 'competen*' and 'primary health care', 'general practice' and 'nurs*') was combined with searching of the Internet using the Google scholar search engine. Experts were approached to identify relevant grey literature. Key websites were also searched and the reference lists of retrieved sources were followed up. The search focussed on English language literature published since 2000. Limited published literature reports on competency standards for nurses working in general practice and primary health care. Of the literature that is available, there are differences in the reporting of how the competency standards were developed. A number of common themes were identified across the included competency standards, including clinical practice, communication, professionalism and health promotion. Many competency standards also included teamwork, education, research/evaluation, information technology and the primary health care environment. Given the potential value of competency standards, further work is required to develop and test robust standards that can communicate the skills and knowledge required of nurses working in primary health care settings to policy makers, employers, other health professionals and consumers. Competency standards are important tools for communicating the role of nurses to consumers and other health professionals, as well as defining this role for employers, policy makers and educators. Understanding the content

  9. Cultural Competence in the College Biology Classroom

    ERIC Educational Resources Information Center

    Tanner, Kimberly; Allen, Deborah

    2007-01-01

    As a general phrase, "cultural competence" can often conjure for the unfamiliar reader a vision of a person who is fair, just, and open, a person who is nice, someone who is a good person at heart. Cultural competence, however, goes far beyond the everyday meanings that its component words invoke, and it is an active area of scholarship and…

  10. Children's Perceived Competence Scale: Reference values in Japan.

    PubMed

    Nagai, Yukiyo; Nomura, Kayo; Nagata, Masako; Ohgi, Shohei; Iwasa, Mitsuji

    2015-12-01

    To support children with chronic diseases, reference values to measure developmental changes in self-perception and self-esteem are considered a useful yardstick. To develop reference values to measure self-perceived competence and self-esteem in Japanese children, the Children's Perceived Competence Scale (CPCS) was administered to 768 children of elementary school grade 1 (6 years) to grade 6 (11 years) at four public schools in Japan, from November to December 2012. After excluding 74 with chronic diseases and/or incomplete responses, 694 children were included. CPCS measures children's self-perceived competence in cognitive, social, physical domains, and general self-worth, namely self-esteem. There was a tendency for scores of cognitive and general self-worth to decrease with increasing grade. Scores among grade 5 respondents were significantly lower than those among grade 4 respondents for both social and physical domains. Scores among boys and girls differed significantly, with boys scoring higher for physical domain in grades 3 and 6 and for general self-worth domain in grade 6. The CPCS reference values to measure self-perceived competence and self-esteem in Japanese children were developed in this study. These reference values are useful to inform practitioners supporting children with psychological or psychiatric problems or those with chronic diseases. © The Author(s) 2014.

  11. Scientific Competencies in the Social Sciences

    ERIC Educational Resources Information Center

    Dietrich, Heike; Zhang, Ying; Klopp, Eric; Brünken, Roland; Krause, Ulrike-Marie; Spinath, Frank M.; Stark, Robin; Spinath, Birgit

    2015-01-01

    The aim of the present study was to introduce a general theoretical model of scientific competencies in higher education and to adapt it to three social sciences, namely psychology, sociology, and political science, by providing evidence from expert interviews and program regulations. Within our general model, we distinguished and specified four…

  12. The Importance of Military Cultural Competence.

    PubMed

    Meyer, Eric G; Writer, Brian W; Brim, William

    2016-03-01

    Military cultural competence has recently gained national attention. Experts have posited that limited outcomes in the treatment of posttraumatic stress disorder and depression in the military may be related to limited familiarity with the military. National surveys have indicated low military cultural competence among providers and limited educational efforts on military culture or pertinent military pathology in medical schools and residency training programs. Military families, with their own unique military cultural identity, have been identified as a population with increased risks associated with deployment. In response to these findings, several curricula regarding military culture have been established and widely distributed. Assessments of military cultural competence have also been developed. The clinical impact of enhanced cultural competence in general has thus far been limited. The military, however, with its highly prescribed cultural identity, may be a model culture for further study.

  13. Aptitude, Achievement and Competence in Medicine: A Latent Variable Path Model

    ERIC Educational Resources Information Center

    Collin, V. Terri; Violato, Claudio; Hecker, Kent

    2009-01-01

    To develop and test a latent variable path model of general achievement, aptitude for medicine and competence in medicine employing data from the Medical College Admission Test (MCAT), pre-medical undergraduate grade point average (UGPA) and demographic characteristics for competence in pre-clinical and measures of competence (United States…

  14. Perspective: Toward a competency framework for faculty.

    PubMed

    Milner, Robert J; Gusic, Maryellen E; Thorndyke, Luanne E

    2011-10-01

    Today, faculty in academic medicine face challenges in all three mission areas--research, education, and patient care--and require a broad set of competencies to survive in this changing environment. To support faculty and to design assessments that match new expectations, the authors argue that it is essential to capture the full scope of skills, knowledge, and behaviors necessary for a successful faculty member. Thus, it is timely to explore and define competencies for faculty in academic medicine. The authors describe three approaches to identifying faculty competencies. Each reveals diverse but overlapping sets of competency domains, reflecting the breadth of activities expected of today's faculty. To organize these competencies into a coherent framework, the authors propose a model based on a typology of competency. A key feature of the model is the division between occupational competencies, which are largely role-specific, and personal competencies, which are necessary for all faculty. A competency framework also must be developmental, to reflect the growth in skills, knowledge, and behaviors from trainee to expert and to allow for an individual's changing roles over a career. Such a competency framework will inform professional development activities and require assessment of competence. The generation of competencies also will reveal areas of faculty practice that are poorly measured, requiring new tools to be incorporated into existing processes of faculty evaluation. The authors provide general principles to guide the identification of a competency framework for faculty and invite the academic medicine community to engage in further discussion.

  15. [Competence based medical education].

    PubMed

    Bernabó, Jorge G; Buraschi, Jorge; Olcese, Juan; Buraschi, María; Duro, Eduardo

    2007-01-01

    The strategy of curriculum planning in the majority of the Schools of Medicine has shifted, in the past years, from curriculum models based in contents to outcome oriented curricula. Coincidently the interest in defining and evaluating the clinical competences that a graduate must have has grown. In our country, and particularly in the Associated Hospitals belonging to the Unidad Regional de Enseñanza IV of the UBA School of Medicine, evidence has been gathered showing that the acquisition of clinical competences during the grade is in general insufficient. The foundations and characteristics of PREM (Programa de Requisitos Esenciales Mínimos) are described. PREM is a tool to promote the apprenticeship of abilities and necessary skills for the practice of medicine. The objective of the program is to promote the apprenticeship of a well defined list of core competences considered indispensable for a general practitioner. An outcome oriented curriculum with a clear definition of the expected knowledge, skills and attitudes of a graduate of the programme, the promotion of learning experiences centered in the practice and evaluation tools based in direct observation of the student's performance should contribute to close the gap between what the Medicine Schools traditionally teach and evaluate, and what the doctor needs to know and needs to do to perform correctly its profession.

  16. 13 CFR 125.5 - What is the Certificate of Competency Program?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Competency Program? 125.5 Section 125.5 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION GOVERNMENT CONTRACTING PROGRAMS § 125.5 What is the Certificate of Competency Program? (a) General. (1) The Certificate of Competency (COC) Program is authorized under section 8(b)(7) of the Small Business Act (15 U.S...

  17. Epistemic Evaluation of the Training and Managerial Competence Development Process

    ERIC Educational Resources Information Center

    Machado, Evelio F.; Zambrano, Marcos T.; Montes de Oca, Nancy

    2015-01-01

    This article presents the problem of defining the concept of "competence", due to it being an integral and complex term that has been applied in many domains as well as in a more general sense for everyday life. However, no doubt, a competence can only be tested and valuated in the practice, and it is a person who becomes competent in a…

  18. [Mental disorder and competence to testify].

    PubMed

    Lau, S; Böhm, C; Volbert, R

    2008-01-01

    The article describes the approach used in the psychiatric assessment of a person's competence to testify and discusses different disorders. Psychiatrists are often asked to comment on the competence to give evidence if witnesses' behaviour suggests psychopathology or they are undergoing psychiatric treatment or psychotherapy. Competence to testify is assessed in two steps. Impaired capacity to give evidence does not necessarily have to be considered unless a psychiatric diagnosis has been made. It is very rare for a witness to be declared incompetent to testify; incompetence is assumed only in the context of classic psychiatric illnesses, psychotic states or intoxications. Other diagnoses generally do not justify the assumption of incompetence to testify.

  19. Competencies for Teachers Who Instruct Children with Learning Disabilities. Project I.O.U.

    ERIC Educational Resources Information Center

    Keegan, William

    The report lists competencies for teachers in every day interactions with learning disabled students. Developed by a task force, the competencies are intended to serve as general guidelines. Information is presented on the goal, assessment competencies, and instructional competencies for the following areas: classroom management, spoken language,…

  20. Electrodiagnostic medicine skills competency in physical medicine and rehabilitation residents: a method for development and assessment.

    PubMed

    Brown, David; Cuccurullo, Sara; Lee, Joseph; Petagna, Ann; Strax, Thomas

    2008-08-01

    This project sought to create an educational module including evaluation methodology to instruct physical medicine and rehabilitation (PM&R) residents in electrodiagnostic evaluation of patients with neuromuscular problems, and to verify acquired competencies in those electrodiagnostic skills through objective evaluation methodology. Sixteen residents were trained by board-certified neuromuscular and electrodiagnostic medicine physicians through technical training, lectures, and review of self-assessment examination (SAE) concepts from the American Academy of Physical Medicine & Rehabilitation syllabus provided in the Archives of Physical Medicine and Rehabilitation. After delivery of the educational module, knowledge acquisition and skill attainment were measured in (1) clinical skill in diagnostic procedures via a procedure checklist, (2) diagnosis and ability to design a patient-care management plan via chart simulated recall (CSR) exams, (3) physician/patient interaction via patient surveys, (4) physician/staff interaction via 360-degree global ratings, and (5) ability to write a comprehensive patient-care report and to document a patient-care management plan in accordance with Medicare guidelines via written patient reports. Assessment tools developed for this program address the basic competencies outlined by the Accreditation Council for Graduate Medical Education (ACGME). To test the success of the standardized educational module, data were collected on an ongoing basis. Objective measures compared resident SAE scores in electrodiagnostics (EDX) before and after institution of the comprehensive EDX competency module in a PM&R residency program. Fifteen of 16 residents (94%) successfully demonstrated proficiency in every segment of the evaluation element of the educational module by the end of their PGY-4 electrodiagnostic rotation. The resident who did not initially pass underwent remedial coursework and passed on the second attempt. Furthermore, the

  1. 46 CFR 11.901 - General provisions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ENDORSEMENTS Subjects of Examinations and Practical Demonstrations of Competence § 11.901 General provisions... competence as set out under the appropriate STCW Regulations (incorporated by reference in § 11.102): (1... of competence under paragraph (c) of this section must meet the appropriate performance standards set...

  2. Professional communication competences of physiotherapists -- practice and educational perspectives.

    PubMed

    Włoszczak-Szubzda, Anna; Jarosz, Mirosław J

    2013-01-01

    Dissonance between the high 'technical' competences of medical professionals, including physiotherapists, and the relatively low level of patient satisfaction with care received is a phenomenon observed in many countries. Many studies show that it occurs in the case of an inadequate interpersonal communication between medical professionals and patients. The primary goal of the presented research was evaluation of the level (study of the state) of communication competences of physiotherapists, and determination of the factors on which this level depends. An additional goal was analysis of the needs and educational possibilities within the existing models of education in the area of interpersonal communication provided by higher medical education institutions. The self-designed questionnaire and adjective check list were subject to standardization from the aspect of reliability and validity. Information available on the websites of 20 educational facilities in Poland were compared. The study group covered a total number of 115 respondents in the following subgroups: 1) occupationally-active physiotherapists who, as a rule, were not trained in interpersonal communication (35 respondents); students of physiotherapy covered by a standard educational programme (60 respondents); 3) students of physiotherapy who, in addition to a standard educational programme, attended extra courses in professional interpersonal communications (20 respondents). The results of studies indicate poor efficacy of shaping communication competences of physiotherapists based on education in the area of general psychology and general interpersonal communication. Communication competences acquired during undergraduate physiotherapy education are subject to regression during occupational activity. Methods of evaluating communication competences are useful in constructing group and individual programmes focused on specific communication competences, rather than on general communication skills.

  3. Competency to consent to research: a psychiatric overview.

    PubMed

    Appelbaum, P S; Roth, L H

    1982-08-01

    The requirement that a subject be competent as a condition of valid consent to participate in research has been accepted by most students of legal and ethical problems of human experimentation. "Competency," however, has lacked a clear and generally agreed on standard. There are four commonly used standards for competency: evidencing a choice in regard to research participation, factual understanding of the issues, rational manipulation of information, and appreciation of the nature of the situation. These standards can be arranged hierarchically such that each represents a stricter test of competency. The decision as to how rigorous a standard for competency is desirable cannot be made on psychiatric grounds. It requires consideration of the policy goals on hopes to attain. Empirical research helps demonstrate the consequences of choosing a particular standard but cannot replace the need for achieving consensus on policy goals.

  4. Resident education in 2011: three key challenges on the road ahead.

    PubMed

    Van Eaton, Erik G; Tarpley, John L; Solorzano, Carmen C; Cho, Clifford S; Weber, Sharon M; Termuhlen, Paula M

    2011-04-01

    Two important changes in the past decade have altered the landscape of graduate medical education (GME) in the U.S. The national restrictions on trainee duty hours mandated by the Accreditation Council for Graduate Medical Education (ACGME) were the most visible and generated much controversy. Equally important is the ACGME Outcome Project, which mandates competency-based training. Both of these changes have unique implications for surgery trainees, who traditionally spent long hours caring for patients in the hospital, and who must be assessed in 2 broad domains: their medical care of pre- and postoperative patients, and their technical skill with procedures in and out of the operating room. This article summarizes 3 key challenges that lie ahead for surgical educators. First, the changes in duty hours in the past 7 years are summarized, and the conversation about added restrictions planned for July 2011 is reviewed. Next, the current state of the assessment of competency among surgical trainees is reviewed, with an outline of the challenges that need to be overcome to achieve widespread, competency-based training in surgery. Finally, the article summarizes the problems caused by increased reliance on handoffs among trainees as they compensate for decreased time in the hospital, and suggests changes that need to be made to improve safety and efficiency, including how to use handoffs as part of our educational evaluation of residents. Copyright © 2011 Mosby, Inc. All rights reserved.

  5. The Analysis of A1 Level Speaking Exam in Terms of Syntax: The Effect of General Competence on Syntax in A1 Level Speaking

    ERIC Educational Resources Information Center

    Misir, Hülya

    2017-01-01

    This study aims at discovering the relevance of general competence of Turkish and Arab learners who have an A1 level of English proficiency in preparatory school of University of Turkish Aeronautical Association (UTAA) to their speaking skill in terms of syntax by analyzing the recordings of speaking exams in the first semester. One can ask why…

  6. Practice-based learning and improvement: a two-year experience with the reporting of morbidity and mortality cases by general surgery residents.

    PubMed

    Falcone, John L; Lee, Kenneth K W; Billiar, Timothy R; Hamad, Giselle G

    2012-01-01

    The Accreditation Council for Graduate Medical Education (ACGME) core competency of practice-based learning and improvement can be assessed with surgical Morbidity and Mortality Conference (MMC). We aim to describe the MMC reporting patterns of general surgery residents, describe the adverse event rate for patients and compare that with existing published rates, and describe the nature of our institutional adverse events. We hypothesize that reporting patterns and incidence rates will remain constant over time. In this retrospective cohort study, archived MMC case lists were evaluated from January 1, 2009 to December 31, 2010. The reporting patterns of the residents, the adverse event ratios, and the specific categories of adverse events were described over the academic years. χ(2) and Fisher's exact tests were used to compare across academic years, using an α = 0.05. There were 85 surgical MMC case lists evaluated. Services achieved a reporting rate above 80% (p < 0.001). The most consistent reporting was done by postgraduate year (PGY) 5 level chief residents for all services (p > 0.05). Out of 11,368 patients evaluated from complete MMC submissions, 289 patients had an adverse event reported (2.5%). This was lower than published reporting rates for patient adverse event rates (p < 0.001). Adverse event rates were consistent for residents at the postgraduate year 2, 4, and 5 levels for all services (p > 0.05). Over 2 years, 522 adverse events were reported for 461 patients. A majority of adverse events were from death (24.1%), hematologic and/or vascular events (16.7%), and gastrointestinal system events (16.1%). Surgery resident MMC reporting patterns and adverse event rates are generally stable over time. This study shows which adverse event cases are important for chief residents to report. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  7. Competent Children at Risk: Their Parents and Families. 2. Markers of Competent Children.

    ERIC Educational Resources Information Center

    Kokes, Ronald F.; And Others

    Hypotheses presented in an initial report of this study were tested and, in general, all were supported. Maternal diagnosis, chronicity, and age of onset with regard to the child and to parent/child interaction were significantly associated with child competence. However, effects of these factors were not consistent across age of child or child…

  8. Cultural Competence and Related Factors Among Taiwanese Nurses.

    PubMed

    Lin, Chin-Nu; Mastel-Smith, Beth; Alfred, Danita; Lin, Yu-Hua

    2015-12-01

    Taiwan is a multicultural and multiethnic society with a growing number of immigrants who have diverse ethnic, racial, and cultural needs. Although this diversity highlights the pressing need for culturally competent healthcare providers, cultural competence is a concept that is little understood and implemented only sporadically in Taiwan. This study investigates the cultural competence of Taiwanese nurses and the related factors of influence. An online self-report survey was used to collect data from 221 Taiwanese nurses from December 2012 through January 2013. Data from the demographic questionnaire, the Nurses' Cultural Competence Scale, and the Perceived Nurses' Cultural Competence Rating were analyzed using descriptive statistics, Pearson correlation, independent sample t tests, and multiple regressions. The cultural competence of the participants was in the "low to moderate" range, with relatively higher mean scores for the subscales of cultural awareness and cultural sensitivity and relatively lower scores for the subscales of cultural knowledge and cultural skills. Participants generally perceived themselves as being "not culturally competent." Variables found to predict cultural competence included years of work experience, hours of continuing education related to cultural nursing care, and frequency of caring for clients from culturally and ethnically diverse backgrounds. Participating Taiwanese nurses rated their level of cultural competence as in the low-to-moderate range and self-perceived as being not culturally competent. These findings support the need to further expand and enhance cultural-competence-related continuing education and to address the topic of cultural care in the nursing curricula.

  9. Exploring the 'cultural' in cultural competencies in Pacific mental health.

    PubMed

    Samu, Kathleen Seataoai; Suaalii-Sauni, Tamasailau

    2009-02-01

    Cultural competency is about the ability of individuals and systems to respond respectfully and effectively to the cultural needs of peoples of all cultures. Its general attributes include knowledge, attitudes, skills and professional judgment. In Pacific mental health, 'the cultural' is generally understood to be ethnic culture. Accordingly, Pacific cultural competencies assume ethnic specific markers. In mental health Pacific cultural competencies has seen a blending of cultural and clinical beliefs and practices. This paper provides an overview of five key theme areas arising from Auckland-based ethnic-specific Pacific workshop data: language, family, tapu relationships, skills and organisation policy. Workshop participants comprised of Pacific mental health providers, Pacific consumers, family members of Pacific consumers and members of the Pacific community members. This paper purports that identifying the perceptions of different Pacific groups on ethnic-specific elements of cultural competencies are necessary to build and strengthen the capacity and capability of mental health services to provide culturally relevant services.

  10. Accrediting Graduate Medical Education in Psychiatry: Past, Present, and Future.

    PubMed

    Johnson, Toni; John, Nadyah Janine; Lang, Michael; Shelton, P G

    2017-06-01

    The current terminology, goals, and general competency framework systematically utilized in the education of residents regardless of specialty is almost unrecognizable and quite foreign to those who trained before 2010. For example, the clinical and professional expectations for physicians-in-training have been placed onto a developmental framework of milestones. The expectations required during training have been expanded to include leadership and team participation skills, proficiency in the use of information technology, systems-based knowledge including respect of resources and cost of care, patient safety, quality improvement, population health and sensitivity to diversity for both individual and populations of patients. With these additions to physician training, the Accreditation Council for Graduate Medical Education (ACGME) hopes to remain accountable to the social contract between medicine and the public. With a focus on psychiatric practice, this article provides a general background and overview of the major overhaul of the accreditation process and educational goals for graduate medical education and briefly highlights possibilities for the future.

  11. Sources of Individual Differences in Emerging Competence With Numeration Understanding Versus Multidigit Calculation Skill

    PubMed Central

    Fuchs, Lynn S.; Geary, David C.; Fuchs, Douglas; Compton, Donald L.; Hamlett, Carol L.

    2014-01-01

    This study investigated contributions of general cognitive abilities and foundational mathematical competencies to numeration understanding (i.e., base-10 structure) versus multidigit calculation skill. Children (n = 394, M = 6.5 years) were assessed on general cognitive abilities and foundational numerical competencies at start of 1st grade; on the same numerical competencies, multidigit calculation skill, and numeration understanding at end of 2nd grade; and on multidigit calculation skill and numeration understanding at end of 3rd grade. Path-analytic mediation analysis revealed that general cognitive predictors exerted more direct and more substantial effects on numeration understanding than on multidigit calculations. Foundational mathematics competencies contributed to both outcomes, but largely via 2nd-grade mathematics achievement, and results suggest a mutually supportive role between numeration understanding and multidigit calculations. PMID:25284885

  12. Resident designed intern orientation to address the new ACGME Common Program Requirements for resident supervision.

    PubMed

    Rialon, Kristy L; Barfield, Michael E; Elfenbein, Dawn M; Lunsford, Keri E; Tracy, Elisabeth T; Migaly, John

    2013-01-01

    To design an orientation for surgical interns to meet the new Accreditation Council for Graduate Medical Education Common Program Requirements regarding supervision, to test patient-management competencies, and to assess confidence on skills and tasks pre-orientation and post-orientation. Twenty-seven incoming surgical interns participated in a two-day orientation to clinical duties. Activities included a pre-test, lectures, simulation, oral examination, intern shadowing, and a post-test. Incoming interns were surveyed before and after orientation and two months later for confidence in patient-management and surgical intern skills. Paired t-tests were used to determine if confidence improved pre-orientation and post-orientation, and two months following orientation. The study took place at an academic training hospital. All (n = 27) postgraduate year-1 (PGY-1) surgical residents at our institution, which included the categorical and nondesignated preliminary general surgery, urology, orthopedic surgery, otolaryngology, and neurosurgery programs. All interns passed the oral and written examinations, and were deemed able to be indirectly supervised, with direct supervision immediately available. They reported increased confidence in all areas of patient management addressed during orientation, and this confidence was retained after two months. In surgical and floor-related tasks and skills, interns reported no increase in confidence directly following orientation. However, after two months, they reported a significant increase in confidence, particularly in those tasks that are performed often. New requirements for resident supervision require creative ways of verifying resident competency in basic skills. This type of orientation is an effective way to address the new requirements of supervision and teach interns the tasks and skills that are necessary for internship. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All

  13. General movements of preterm infants in relation to their motor competence between 5 and 6 years.

    PubMed

    Sustersic, Breda; Sustar, Katja; Paro-Panjan, Darja

    2012-11-01

    The criteria for identification of children with high risk of cerebral palsy are well documented, but the early identification of children at highest risk of minor motor deficits remains less clear. To analyze the correlation between the quality of general movements (GMs) from term to twenty weeks postterm age and the motor competence between 5 and 6 years of age. In the group of 45 preterm infants, the quality of GMs was assessed using Prechtl's method. The Movement Assessment Battery for Children (M-ABC) was used to test motor competence between 5 and 6 years of age. The correlations between GMs and M-ABC results were analyzed. During writhing period, the sensitivity of GMs to identify children with definite motor problem was 0.86 for total impairment, 0.67 for manual dexterity, 0.89 for ball skills and 0.92 for balance. During fidgety period, the sensitivity was higher than during the writhing period: 1.00 for total impairment, 1.00 for manual dexterity, 1.00 for ball skills and 0.83 for balance, respectively. The specificity was low at both ages (total scoring 0.24 at term and 0.21 at 3 months corrected age). The sensitivity of GMs to identify children with definite motor problems is higher at the fidgety than at the writhing period. The specificity of GMs at the term and fidgety age to predict later motor abilities is low. Copyright © 2012 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  14. Smartphone Addiction and Interpersonal Competence of Nursing Students

    PubMed Central

    LEE, Sunhee; KIM, Hye-Jin; CHOI, Han-Gyo; YOO, Yang Sook

    2018-01-01

    Background: Interpersonal competence is an important capacity for nurses. Recently, the advent of smartphones has instigated considerable changes in daily life. Because smartphone has multiple functions, people tend to use them for numerous activities, often leading to addictive behavior. Methods: This cross-sectional study performed a detailed analysis of smartphone addiction subscales and social support related to interpersonal competence of nursing students. Overall, 324 college students were recruited at Catholic University in Seoul, Korea from Feb 2013 to Mar 2013. Participants completed a self-reported questionnaire, which included scales that measured smartphone addiction, social support, interpersonal competence, and general characteristics. Path analysis was used to evaluate structural relations between subscales of smartphone addictions, social support, and interpersonal competence. Results: The effect of cyberspace-oriented relationships and social support on interpersonal competence were 1.360 (P=.004) and 0.555 (P<.001), respectively. Conclusion: Cyberspace-oriented relationship, which is a smartphone addiction subscale, and social support were positively correlated with interpersonal competence of nursing students, while other smartphone addiction subscales were not related to nursing student interpersonal competence. Therefore, effective smartphone teaching methods be developed to enhance nursing student motivation PMID:29845021

  15. Smartphone Addiction and Interpersonal Competence of Nursing Students.

    PubMed

    Lee, Sunhee; Kim, Hye-Jin; Choi, Han-Gyo; Yoo, Yang Sook

    2018-03-01

    Interpersonal competence is an important capacity for nurses. Recently, the advent of smartphones has instigated considerable changes in daily life. Because smartphone has multiple functions, people tend to use them for numerous activities, often leading to addictive behavior. This cross-sectional study performed a detailed analysis of smartphone addiction subscales and social support related to interpersonal competence of nursing students. Overall, 324 college students were recruited at Catholic University in Seoul, Korea from Feb 2013 to Mar 2013. Participants completed a self-reported questionnaire, which included scales that measured smartphone addiction, social support, interpersonal competence, and general characteristics. Path analysis was used to evaluate structural relations between subscales of smartphone addictions, social support, and interpersonal competence. The effect of cyberspace-oriented relationships and social support on interpersonal competence were 1.360 ( P =.004) and 0.555 ( P <.001), respectively. Cyberspace-oriented relationship, which is a smartphone addiction subscale, and social support were positively correlated with interpersonal competence of nursing students, while other smartphone addiction subscales were not related to nursing student interpersonal competence. Therefore, effective smartphone teaching methods be developed to enhance nursing student motivation.

  16. Sources of Individual Differences in Emerging Competence with Numeration Understanding versus Multidigit Calculation Skill

    ERIC Educational Resources Information Center

    Fuchs, Lynn S.; Geary, David C.; Fuchs, Douglas; Compton, Donald L.; Hamlett, Carol L.

    2014-01-01

    This study investigated contributions of general cognitive abilities and foundational mathematical competencies to numeration understanding (i.e., base-10 structure) versus multidigit calculation skill. Children (n = 394, M = 6.5 years) were assessed on general cognitive abilities and foundational numerical competencies at start of 1st grade; on…

  17. South Dakota Middle School Mathematics Teachers' Perceptions of Teaching Competencies

    ERIC Educational Resources Information Center

    Bleecker, Heather A.

    2017-01-01

    This quantitative research study investigates South Dakota middle school (grades 5-8) mathematics teachers' perceptions of teaching competencies including general pedagogical knowledge (GPK) and mathematical pedagogical content knowledge (MPCK). The study also considered how teacher characteristics relate to teacher competencies. The study…

  18. Representations and processes of human spatial competence.

    PubMed

    Gunzelmann, Glenn; Lyon, Don R

    2011-10-01

    This article presents an approach to understanding human spatial competence that focuses on the representations and processes of spatial cognition and how they are integrated with cognition more generally. The foundational theoretical argument for this research is that spatial information processing is central to cognition more generally, in the sense that it is brought to bear ubiquitously to improve the adaptivity and effectiveness of perception, cognitive processing, and motor action. We describe research spanning multiple levels of complexity to understand both the detailed mechanisms of spatial cognition, and how they are utilized in complex, naturalistic tasks. In the process, we discuss the critical role of cognitive architectures in developing a consistent account that spans this breadth, and we note some areas in which the current version of a popular architecture, ACT-R, may need to be augmented. Finally, we suggest a framework for understanding the representations and processes of spatial competence and their role in human cognition generally. Copyright © 2011 Cognitive Science Society, Inc.

  19. Poor Sleep Is Related to Lower Emotional Competence Among Adolescents.

    PubMed

    Brand, Serge; Kirov, Roumen; Kalak, Nadeem; Gerber, Markus; Schmidt, Norman B; Lemola, Sakari; Correll, Christoph U; Holsboer-Trachsler, Edith

    2016-01-01

    The aim of the present study was to explore the association between subjective insomnia and self-reported emotional competence in areas such as regulating and perceiving one's own emotions and empathy, in a sample of adolescents. Gender differences were also explored. 366 adolescents in 10th to 12th grade (mean age: M = 16.9 years) took part in this cross-sectional study. They completed questionnaires related to emotional competencies, empathy, and sleep. Higher scores for insomnia were associated with lower scores for some aspects of emotional competence and empathy. Compared to males, females generally had higher scores for emotional competence. Poor sleep as subjectively experienced among adolescents is associated with specific impairments in emotional competence and empathy. Gender-related patterns were also observed.

  20. Native American health: traditional healing and culturally competent health care internet resources.

    PubMed

    Carlock, Danielle

    2006-01-01

    Health disparities between Native Americans and the general population of the United States are a major health concern. Traditional healing and culturally competent health care offer much promise in raising the health status of Native Americans. Traditional healing, although uniquely practiced by each indigenous culture, is generally a system of medicine based on the inseparability of mind, body, and spirit. Culturally competent health care, care that is congruent with the culture and language of the patient, is a growing initiative in western medicine. This article outlines Internet sites and online resources relevant to the study and practice of traditional healing and culturally competent health care.

  1. [From the Principle of Beneficence to the Principle of Autonomy. Assessment of Patients' Mental Competency in the General Hospital].

    PubMed

    Diana, Restrepo B; Carlos, Cardeño C; Marle, Duque G; Santiago, Jaramillo

    2012-06-01

    Refusing a medical procedure is a valid way of exercising every patient's right to autonomy. From the legal point of view, autonomy is based on the right to privacy. In recent decades the legal right to self-determination has gradually expanded and today patients in full possession of their mental faculties, have the moral and legal right to make their own decisions and these decisions take precedence over physician and family. Often liaison psychiatrists are called in to assess the mental competence of patients in the general hospital. To determine the psychiatrist's role in evaluating these patients. The assessment of a patient's ability to decide and self-determine is a common clinical problem in general hospitals. Evaluation of these patients requires a proper understanding of the philosophical, ethical, and legal issues that guide the appropriate treatment of these complex clinical problems. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  2. Development of the Holistic Nursing Competence Scale.

    PubMed

    Takase, Miyuki; Teraoka, Sachiko

    2011-12-01

    This study developed a scale to measure the nursing competence of Japanese registered nurses and to test its psychometric properties. Following the derivation of scale items and pilot testing, the final version of the scale was administered to 331 nurses to establish its internal consistency, as well as its construct and criterion-related validity. Using an exploratory and a confirmatory factor analysis, 36 items with a five-factor structure were retained to form the Holistic Nursing Competence Scale. These factors illustrate nurses' general aptitude and their competencies in staff education and management, ethical practice, the provision of nursing care, and professional development. The Scale has a positive correlation with the length of clinical experience. A Cronbach's alpha coefficient was 0.967. The Scale is a reliable and valid measure, helping both nurses and organizations to correctly evaluate nurses' competence and identify their needs for professional development. © 2011 Blackwell Publishing Asia Pty Ltd.

  3. [The debate on the development of advanced competences].

    PubMed

    Dimonte, Valerio; Palese, Alvisa; Chiari, Paolo; Laquintana, Dario; Tognoni, Gianni; Di Giulio, Paola

    2016-01-01

    . The debate on the development of advanced nursing competences. The dossier aims to describe and disentagle the present Italian and international debate on the development and recognition of advanced nursing competences. Following a general brief description of the legislative national background, the attention is first of all focused on the lack of clarity on the definition of advanced competence, which is further complicated by the issue of their formal, contractual and economic recognition. To explore these issues a list of contributions is presented and some proposals are formulated to favor a better oriented development of the debate: a. A convenience sample of 139 nurses were interviewed asking to describe problems occurred in the last month that could prompt the intervention of an expert nurse and to list the clinical, managerial and educational competences of a specialized nurse in their ward. The results document the quality and the dispersion of the definitions which are perceived and applied in the general settings of care. b. The issue the post basic courses (master, specialization) offered to nurses in 2015-2016 by Italian universities were described and their aims. While the contribution of the courses in increasing the theoretical knowledge is well defined, the aims and the description of the clinical training are badly developed and an acquisition of advanced competences would seem unlikely. c. The definition of advanced competences was explored in the international literature: while evidences are available on the impact of advanced nursing on patients' outcomes, what is advanced nursing is far from being clear, and an impressive list of roles, activities and functions are considered advanced. d. Although at national level there is no formal recognition for nurses with advanced competences (with the exception of the head nurse that holds mostly an organizational rather than clinical role), the opportunities for promoting the role of specialistic

  4. Management competencies: intrinsic or acquired? What competencies are required to move into speech pathology management and beyond?

    PubMed

    Pilling, Samantha; Slattery, Justine

    2004-01-01

    Speech pathology managers frequently move into careers beyond their clinical discipline. As practicing speech pathology managers and students of business leadership, we were curious about the nature of career transitions out of speech pathology management. We conducted an exploratory descriptive study investigating the perceived competencies that facilitate such career transitions and when further education is required to effectively equip one for such transition. The perceived skills related to a speech pathology background are identified along with the gaps in competence for moving into general management positions. Career management practices that facilitate this type of career transition are provided as recommendations for career planning.

  5. Self-Perceived Competence and Social Acceptance of Young Children Who Stutter: Initial Findings

    PubMed Central

    Hertsberg, Naomi; Zebrowski, Patricia M.

    2016-01-01

    Purpose The goals of this study were to determine whether young children who stutter (CWS) perceive their own competence and social acceptance differently than young children who do not stutter (CWNS), and to identify the predictors of perceived competence and social acceptance in young speakers. Method We administered the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children (PSPCSA; Harter & Pike, 1984) to 13 CWS and 14 CWNS and examined group differences. We also collected information on the children's genders, temperaments, stuttering frequencies, language abilities, and phonological skills to identify which of these factors predicted PSPCSA scores. Results CWS, as a group, did not differ from CWNS in their perceived general competence or social acceptance. Gender predicted scores of perceived general competence, and stuttering frequency predicted perceived social acceptance. Temperament, language abilities, and phonological skills were not significant predictors of perceived competence or social acceptance in our sample. Conclusions While CWS did not significantly differ from CWNS in terms of perceived competence and social acceptance, when both talker groups were considered together, girls self-reported greater perceived competence than boys. Further, lower stuttering frequency was associated with greater perceived social acceptance. These preliminary findings provide motivation for further empirical study of the psychosocial components of childhood stuttering. PMID:27614314

  6. Surgery and Medicine Residents' Perspectives of Morbidity and Mortality Conference: An Interdisciplinary Approach to Improve ACGME Core Competency Compliance.

    PubMed

    Flynn-O'Brien, Katherine T; Mandell, Samuel P; Eaton, Erik Van; Schleyer, Anneliese M; McIntyre, Lisa K

    2015-01-01

    Morbidity and mortality conferences (MMCs) are often used to fulfill the Accreditation Council for Graduate Medical Education practice-based learning and improvement (PBLI) competency, but there is variation among institutions and disciplines in their approach to MMCs. The objective of this study is to examine the trainees' perspective and experience with MMCs and adverse patient event (APE) reporting across disciplines to help guide the future implementation of an institution-wide, workflow-embedded, quality improvement (QI) program for PBLI. Between April 1, 2013, and May 8, 2013, surgical and medical residents were given a confidential survey about APE reporting practices and experience with and attitudes toward MMCs and other QI/patient safety initiatives. Descriptive statistics and univariate analyses using the chi-square test for independence were calculated for all variables. Logistic regression and ordered logistic regression were used for nominal and ordinal categorical dependent variables, respectively, to calculate odds of reporting APEs. Qualitative content analysis was used to code free-text responses. A large, multihospital, tertiary academic training program in the Pacific Northwest. Residents in all years of training from the Accreditation Council for Graduate Medical Education-accredited programs in surgery and internal medicine. Survey response rate was 46.2% (126/273). Although most respondents agreed or strongly agreed that knowledge of and involvement in QI/patient safety activities was important to their training (88.1%) and future career (91.3%), only 10.3% regularly or frequently reported APEs to the institution's established electronic incident reporting system. Senior-level residents in both surgery and medicine were more likely to report APEs than more junior-level residents were (odds ratio = 4.8, 95% CI: 3.1-7.5). Surgery residents had a 4.9 (95% CI: 2.3-10.5) times higher odds than medicine residents had to have reported an APE to

  7. Comparisons of Social Competence in Young Children With and Without Hearing Loss: A Dynamic Systems Framework

    PubMed Central

    Hoffman, Michael F.; Quittner, Alexandra L.; Cejas, Ivette

    2015-01-01

    This study compared levels of social competence and language development in 74 young children with hearing loss and 38 hearing peers aged 2.5–5.3 years. This study was the first to examine the relationship between oral language and social competence using a dynamic systems framework in children with and without hearing loss. We hypothesized that, due to deficits in oral language, children who were deaf would display lower levels of social competence than their hearing peers. Furthermore, language age would predict social competence scores. Social competence was measured with a general and deaf-specific measure. Results showed that children with hearing loss performed significantly worse than hearing peers on the general measure but better than the norms on the deaf-specific measure. Controlling for maternal education and income, regression analyses indicated that hearing status and language age predicted social competence in both groups. Among children with hearing loss, correlations were also found between age at diagnosis, age at amplification, and two of the general social competence measures. Results supported our hypothesis that deficits in language would have cascading negative effects on the development of social competence in young deaf children. Development of early intervention programs that target both language and social skills are needed for this population. PMID:25583707

  8. Regents Examinations and Competency Tests. School Administrator's Manual, June 1985 Edition.

    ERIC Educational Resources Information Center

    1985

    Intended for use by school administrators, guidance counselors, teachers and proctors, this manual contains general information on the New York State Regents examinations and competency tests, as well as specific regulations and procedures for ordering, administering, and rating these examinations. The competency testing requirements for a local…

  9. [Development of a pharmacological curriculum for general practice: Identifying and prescribing orally administered pharmacological substances with relevance for general practice].

    PubMed

    Straßner, Cornelia; Kaufmann-Kolle, Petra; Flum, Elisabeth; Schwill, Simon; Brandt, Bettina; Steinhäuser, Jost

    2017-05-01

    General practitioners (GPs) are among the specialists who prescribe the highest number of medication. Therefore the improvement of pharmacological competencies is an important part of the GP specialist training. The self-concept of general practice stating that GPs are the first contact persons for all health problems makes it challenging to define and acquire competencies for specialist training. While the "Competence-based Curriculum" developed by the German College of General Practitioners and Family Physicians defines diagnoses, reasons for counselling and competencies which are essential for general practice, a similar orientation guide is lacking for the pharmacological field. The aim of this study is to define and characterize pharmacological substances which every GP should know so well that he or she is able to conduct counselling and monitoring. We analysed private and public health insurance prescriptions of all general practices participating in the CONTENT project in the period from 2009 to 2014. The analysis was limited to substances with oral application which were prescribed at least once by at least 25 % (n = 11) of the practices. While the 100 most frequent prescriptions were included due to their frequency, less frequently prescribed substances were assessed concerning their relevance for general practice in a rating procedure. The substances included were classified by diagnoses and reasons for counselling. We analysed 1,912,896 prescriptions from 44 practices and 112,535 patients on the basis of the Anatomical Therapeutic Chemical (ATC) classification system. After applying the inclusion criteria, 453 substances were left, 302 of which were considered relevant for general practice and could be assigned to 45 diagnoses / reasons for counselling. The result of this study could be considered a working draft for a pharmacological curriculum for general practice, which may complement the "Competence-based Curriculum" in the medium term. Copyright

  10. Competence skills help deter smoking among inner city adolescents

    PubMed Central

    Epstein, J.; Griffin, K.; Botvin, G.

    2000-01-01

    OBJECTIVE—To test whether higher levels of general competence are linked to more frequent use of refusal assertiveness that is in turn related to less subsequent smoking among inner city adolescents.
METHODS—Longitudinal study conducted during three year middle school or junior high school period. A sample of 1459 students attending 22 middle (ages 11-14 years) and junior high (ages 12-15 years) schools in New York City participated. Students completed surveys at baseline, one year follow up, and two year follow up. The students self reported smoking, decision making skills, personal efficacy, and refusal assertiveness. Teams of three to five data collectors administered the questionnaire following a standardised protocol. These data were collected in school during a regular 40 minute class period.
RESULTS—Based on the tested structural equation model, decision making and personal efficacy (that is, general competence) predicted higher refusal assertiveness and this greater assertiveness predicted less smoking at the two year follow up. The tested model had a good fit and was parsimonious and consistent with theory.
CONCLUSIONS—Adolescent smoking prevention programmes often teach refusal skills in order to help youth resist peer pressure to smoke. The present findings suggest that teaching general competence skills as well may help to reduce smoking because youth with better personal efficacy and decision making skills are better able to implement smoking refusal strategies.


Keywords: adolescent smoking; competence skills; refusal assertiveness; peer pressure PMID:10691756

  11. Assessing Integration of Clinical and Public Health Skills in Preventive Medicine Residencies: Using Competency Mapping

    PubMed Central

    Sarigiannis, Amy N.; Boulton, Matthew L.

    2012-01-01

    Objectives. We evaluated the utility of a competency mapping process for assessing the integration of clinical and public health skills in a newly developed Community Health Center (CHC) rotation at the University of Michigan School of Public Health Preventive Medicine residency. Methods. Learning objectives for the CHC rotation were derived from the Accreditation Council for Graduate Medical Education core clinical preventive medicine competencies. CHC learning objectives were mapped to clinical preventive medicine competencies specific to the specialty of public health and general preventive medicine. Objectives were also mapped to The Council on Linkages Between Academia and Public Health Practice’s tier 2 Core Competencies for Public Health Professionals. Results. CHC learning objectives mapped to all 4 (100%) of the public health and general preventive medicine clinical preventive medicine competencies. CHC population-level learning objectives mapped to 32 (94%) of 34 competencies for public health professionals. Conclusions. Utilizing competency mapping to assess clinical–public health integration in a new CHC rotation proved to be feasible and useful. Clinical preventive medicine learning objectives for a CHC rotation can also address public health competencies. PMID:22690972

  12. Multi-Cultural Competency-Based Vocational Curricula. Clerical Clusters. Multi-Cultural Competency-Based Vocational/Technical Curricula Series.

    ERIC Educational Resources Information Center

    Hepburn, Larry; Shin, Masako

    This document, one of eight in a multi-cultural competency-based vocational/technical curricula series, is on clerical occupations. This program is designed to run 36 weeks and cover 10 instructional areas: beginning typing, typing I, typing II, duplicating, receptionist activities, general office procedures, operation of electronic calculator,…

  13. Assessing curriculum effectiveness: a survey of Uniformed Services University medical school graduates.

    PubMed

    Picho, Katherine; Gilliland, William R; Artino, Anthony R; DeZee, Kent J; Dong, Ting; McManigle, John E; Cruess, David F; Durning, Steven J

    2015-04-01

    This study assessed alumni perceptions of their preparedness for clinical practice using the Accreditation Council for Graduate Medical Education (ACGME) competencies. We hypothesized that our alumni's perception of preparedness would be highest for military-unique practice and professionalism and lowest for system-based practice and practice-based learning and improvement. 1,189 alumni who graduated from the Uniformed Services University (USU) between 1980 and 2001 completed a survey modeled to assess the ACGME competencies on a 5-point, Likert-type scale. Specifically, self-reports of competencies related to patient care, communication and interpersonal skills, medical knowledge, professionalism, systems-based practice, practice-based learning and improvement, and military-unique practice were evaluated. Consistent with our expectations as the nation's military medical school, our graduates were most confident in their preparedness for military-unique practice, which included items assessing military leadership (M = 4.30, SD = 0.65). USU graduates also indicated being well prepared for the challenges of residency education in the domain of professionalism (M = 4.02, SD = 0.72). Self-reports were also high for competencies related to patient care (M = 3.86, SD = 0.68), communication and interpersonal skills (M = 3.88, SD = 0.66), and medical knowledge (M = 3.78, SD = 0.73). Consistent with expectations, systems-based practice (M = 3.50, SD = 0.70) and practice-based learning and improvement (M = 3.57, SD = 0.62) were the lowest rated competencies, although self-reported preparedness was still quite high. Our findings suggest that, from the perspective of our graduates, USU is providing both an effective military-unique curriculum and is preparing trainees for residency training. Further, these results support the notion that graduates are prepared to lead and to practice medicine in austere environments. Compared to other competencies that were assessed, self

  14. Practitioners' Ideas on Laboratory Skills Competencies Needed for Physical Science Teachers

    ERIC Educational Resources Information Center

    James, Robert K.; Schaaf, Joel

    1975-01-01

    In order to determine the competencies needed for teaching secondary physical science a survey of a sample of physical science teachers in Kansas secondary schools was conducted. The major competencies reported could be classified under the following general headings: equipment purchase and operation, maintenance of laboratory safety, and…

  15. Application of cognitive diagnosis models to competency-based situational judgment tests.

    PubMed

    García, Pablo Eduardo; Olea, Julio; De la Torre, Jimmy

    2014-01-01

    Profiling of jobs in terms of competency requirements has increasingly been applied in many organizational settings. Testing these competencies through situational judgment tests (SJTs) leads to validity problems because it is not usually clear which constructs SJTs measure. The primary purpose of this paper is to evaluate whether the application of cognitive diagnosis models (CDM) to competency-based SJTs can ascertain the underlying competencies measured by the items, and whether these competencies can be estimated precisely. The generalized deterministic inputs, noisy "and" gate (G-DINA) model was applied to 26 situational judgment items measuring professional competencies based on the great eight model. These items were applied to 485 employees of a Spanish financial company. The fit of the model to the data and the convergent validity between the estimated competencies and personality dimensions were examined. The G-DINA showed a good fit to the data and the estimated competency factors, adapting and coping and interacting and presenting were positively related to emotional stability and extraversion, respectively. This work indicates that CDM can be a useful tool when measuring professional competencies through SJTs. CDM can clarify the competencies being measured and provide precise estimates of these competencies.

  16. Impact of Placement Type on the Development of Clinical Competency in Speech-Language Pathology Students

    ERIC Educational Resources Information Center

    Sheepway, Lyndal; Lincoln, Michelle; McAllister, Sue

    2014-01-01

    Background: Speech-language pathology students gain experience and clinical competency through clinical education placements. However, currently little empirical information exists regarding how competency develops. Existing research about the effectiveness of placement types and models in developing competency is generally descriptive and based…

  17. Adult Competency Education Kit. Basic Skills in Speaking, Math, and Reading for Employment. Part G. ACE Competency Based Job Descriptions: #22--Refrigerator Mechanic; #24--Motorcycle Repairperson.

    ERIC Educational Resources Information Center

    San Mateo County Office of Education, Redwood City, CA. Career Preparation Centers.

    This fourth of fifteen sets of Adult Competency Education (ACE) Competency Based Job Descriptions in the ACE kit contains job descriptions for Refrigerator Mechanic and Motorcycle Repairperson. Each begins with a fact sheet that includes this information: occupational title, D.O.T. code, ACE number, career ladder, D.O.T. general educational…

  18. Competence to waive interrogation rights and adjudicative competence in adolescent defendants: cognitive development, attorney contact, and psychological symptoms.

    PubMed

    Viljoen, Jodi L; Roesch, Ronald

    2005-12-01

    Although there is growing evidence of developmental differences in competency to waive interrogation rights and adjudicative competence, the correlates of adolescents' legal capacities remain unclear. This study examined the relationship of legal capacities to cognitive development, legal learning opportunities, and psychological symptoms. Participants were 152 male and female defendants aged 11-17, who completed Grisso's Instruments for Assessing Understanding and Appreciation of Miranda Rights, the Fitness Interview Test (Revised Edition), the Woodcock-Johnson III Cognitive Assessment Battery, and the Brief Psychiatric Rating Scale for Children. Legal capacities relevant to interrogation and adjudication increased with age. These developmental differences were partially mediated or explained by cognitive development. Of the specific cognitive abilities examined (general intellectual ability, verbal ability, reasoning, long-term retrieval, attention, and executive functioning), verbal ability was a particularly strong predictor of performance on competency measures. Also, defendants obtained lower scores on competency measures if they showed evidence of attention deficits or hyperactivity, had spent limited time with their attorneys, and/or were from low socioeconomic backgrounds.

  19. Online cultural competency education for millennial dental students.

    PubMed

    Evans, Lorraine; Hanes, Philip J

    2014-06-01

    Teaching cultural competence is now an educational requirement for U.S. dental curricula to meet 2013 accreditation standards. The question now is, given time restrictions, limited resources, and budget constraints faced by the majority of dental schools, how can they provide effective cultural competency education to prepare future dental professionals? An additional concern regarding instruction is the recent focus on techniques to engage Millennial learners since this generation is characterized as technologically savvy with a preference for multimedia and general dislike of traditional lectures. With these issues in mind, Georgia Regents University developed Healthy Perspectives, an online, interactive course in cultural competence designed to engage Millennial students. Both before and after the course, the students were asked to complete a modified version of the Clinical Cultural Competency Questionnaire. Of the eighty-eight students in the course (eighty-one first-year dental students and seven entering radiology students), seventy-one completed the questionnaire both before and after the course, for an 81 percent response rate. Seventy-five students also completed the course evaluation. The pre and post questionnaires showed statistically significant gains for students across the four primary areas of self-awareness, knowledge, attitudes, and skills. Student evaluations of the course were generally positive, particularly regarding content, but somewhat surprisingly their assessment of the interactive components (which were designed to meet generational expectations) was ambivalent.

  20. Competency courts: a creative solution for restoring competency to the competency process.

    PubMed

    Finkle, Michael J; Kurth, Russell; Cadle, Christopher; Mullan, Jessica

    2009-01-01

    It is well accepted that jail is a poor setting for treating the acutely mentally ill, yet the number of mentally ill persons in jail has increased such that Los Angeles County Jail and Riker's Island in New York house more mentally ill than any psychiatric hospital. The number of mentally ill persons charged with a crime whose competency to stand trial is in question has also increased dramatically. Inefficiencies within the competency process result in mentally ill persons charged with crimes remaining in jail longer than necessary. One solution is "competency court", a specialty court within a mental health court. The same judges, attorneys, and mental health professionals staff both courts. By combining their Mental Health Court experience, they can work with the mentally ill using their expertise in competency law and processes, and thereby improve the competency process and reduce the unnecessary time that mentally ill persons spend in jail. (c) 2009 John Wiley & Sons, Ltd.

  1. Assessment of Military Cultural Competence: A Pilot Study.

    PubMed

    Meyer, Eric G; Hall-Clark, Brittany N; Hamaoka, Derrick; Peterson, Alan L

    2015-08-01

    Cultural competence is widely considered a cornerstone of patient care. Efforts to improve military cultural competency have recently gained national attention. Assessment of cultural competence is a critical component to this effort, but no assessment of military cultural competence currently exists. An assessment of military cultural competence (AMCC) was created through broad input and consensus. Careful review of previous cultural competency assessment designs and analysis techniques was considered. The AMCC was organized into three sections: skills, attitudes, and knowledge. In addition to gathering data to determine absolute responses from groups with different exposure levels to the military (direct, indirect, and none), paired questions were utilized to assess relative competencies between military culture and culture in general. Piloting of the AMCC revealed significant differences between military exposure groups. Specifically, those with personal military exposure were more likely to be in absolute agreement that the military is a culture, were more likely to screen for military culture, and had increased knowledge of military culture compared to those with no military exposure. Relative differences were more informative. For example, all groups were less likely to agree that their personal culture could be at odds with military culture as compared to other cultures. Such perceptions could hinder asking difficult questions and thus undermine care. The AMCC is a model for the measurement of the skills, attitudes, and knowledge related to military cultural competence. With further validity testing, the AMCC will be helpful in the critical task of measuring outcomes in ongoing efforts to improve military cultural competence. The novel approach of assessing variance appears to reduce bias and may also be helpful in the design of other cultural competency assessments.

  2. Generalized random sign and alert delay models for imperfect maintenance.

    PubMed

    Dijoux, Yann; Gaudoin, Olivier

    2014-04-01

    This paper considers the modelling of the process of Corrective and condition-based Preventive Maintenance, for complex repairable systems. In order to take into account the dependency between both types of maintenance and the possibility of imperfect maintenance, Generalized Competing Risks models have been introduced in "Doyen and Gaudoin (J Appl Probab 43:825-839, 2006)". In this paper, we study two classes of these models, the Generalized Random Sign and Generalized Alert Delay models. A Generalized Competing Risks model can be built as a generalization of a particular Usual Competing Risks model, either by using a virtual age framework or not. The models properties are studied and their parameterizations are discussed. Finally, simulation results and an application to real data are presented.

  3. Setting Standards for Minimum Competency Tests.

    ERIC Educational Resources Information Center

    Mehrens, William A.

    Some general questions about minimum competency tests are discussed, and various methods of setting standards are reviewed with major attention devoted to those methods used for dichotomizing a continuum. Methods reviewed under the heading of Absolute Judgments of Test Content include Nedelsky's, Angoff's, Ebel's, and Jaeger's. These methods are…

  4. The Singapore-Cambridge General Certificate of Education Advanced-Level General Paper Examination

    ERIC Educational Resources Information Center

    Hassan, Nurul Huda; Shih, Chih-Min

    2013-01-01

    This article describes and reviews the Singapore-Cambridge General Certificate of Education Advanced Level General Paper (GP) examination. As a written test that is administered to preuniversity students, the GP examination is internationally recognised and accepted by universities and employers as proof of English competence. In this article, the…

  5. Work hours reform: perceptions and desires of contemporary surgical residents.

    PubMed

    Whang, Edward E; Perez, Alexander; Ito, Hiromichi; Mello, Michelle M; Ashley, Stanley W; Zinner, Michael J

    2003-10-01

    New Accreditation Council for Graduate Medical Education (ACGME) requirements on resident duty hours are scheduled to undergo nationwide implementation in July 2003. General surgery residents, because of their long duty hours, are likely to be among those most affected by changes imposed to comply with the ACGME requirements. There are few contemporary data on their attitudes toward work hours reform. The study entailed a region-wide survey of residents enrolled in general surgery residencies in New England to characterize the perceptions and desires of surgical residents on the issue of work hours reform. Respondents reported working a mean of 105 +/- 0.7 hours per week, considerably more than the 80-hour limit stipulated by the ACGME. Of the respondents, 81% reported that sleep deprivation had negatively affected their work. A strong majority of respondents believe that work hours reform would improve their quality of life but less than one half expect it to have a positive impact on patient care. A greater percentage of senior residents than junior residents (p < 0.05) have negative perceptions of work hour limitations, particularly with respect to consequences for patient care. Other findings suggest that residents who have actually experienced work hour restrictions are less positive about such restrictions than these residents who had not yet experienced them. Changes imposed by residency programs to comply with work hour requirements might have detrimental effects on senior residents and patient care. The impact of such changes should be carefully monitored as the ACGME requirements are implemented.

  6. Self-perceived competence and social acceptance of young children who stutter: Initial findings.

    PubMed

    Hertsberg, Naomi; Zebrowski, Patricia M

    The goals of this study were to determine whether young children who stutter (CWS) perceive their own competence and social acceptance differently than young children who do not stutter (CWNS), and to identify the predictors of perceived competence and social acceptance in young speakers. We administered the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children (PSPCSA; Harter & Pike, 1984) to 13 CWS and 14 CWNS and examined group differences. We also collected information on the children's genders, temperaments, stuttering frequencies, language abilities, and phonological skills to identify which of these factors predicted PSPCSA scores. CWS, as a group, did not differ from CWNS in their perceived general competence or social acceptance. Gender predicted scores of perceived general competence, and stuttering frequency predicted perceived social acceptance. Temperament, language abilities, and phonological skills were not significant predictors of perceived competence or social acceptance in our sample. While CWS did not significantly differ from CWNS in terms of perceived competence and social acceptance, when both talker groups were considered together, girls self-reported greater perceived competence than boys. Further, lower stuttering frequency was associated with greater perceived social acceptance. These preliminary findings provide motivation for further empirical study of the psychosocial components of childhood stuttering. Readers will be able to describe the constructs of perceived competence and social acceptance in young children, and whether early stuttering plays a role in the development of these constructs. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Competency-based medical education: An overview and application in pharmacology

    PubMed Central

    Shah, Nilima; Desai, Chetna; Jorwekar, Gokul; Badyal, Dinesh; Singh, Tejinder

    2016-01-01

    Competency-based medical education (CBME) is gaining momentum across the globe. The Medical Council of India has described the basic competencies required of an Indian Medical Graduate and designed a competency-based module on attitudes and communication. Widespread adoption of a competency-based approach would mean a paradigm shift in the current approach to medical education. CBME, hence, needs to be reviewed for its usefulness and limitations in the Indian context. This article describes the rationale of CBME and provides an overview of its components, i.e., competency, entrustable professional activity, and milestones. It elaborates how CBME could be implemented in an institute, in the context of basic sciences in general and pharmacology in particular. The promises and perils of CBME that need to be kept in mind to maximize its gains are described. PMID:28031599

  8. Behavioral Interviewing: Integrating ACGME Competency-Based Questions Into the Radiology Resident Selection Process.

    PubMed

    McArthur, Tatum A; Flug, Jonathan A; Restauri, Nicole

    The practice of radiology is continually evolving with external pressures increasing the involvement of the radiologist as an integrated member of the multidisciplinary care delivery team and not just image interpreters working in isolation. Radiologists need to be comfortable interacting directly with patients and practicing "patient and family-centered care" and "value-based medicine." Despite this evolving role of the radiologist, medical training and the residency selection process have not significantly adapted to accommodate these new demands. In order to develop and hire radiologists who can excel in this role, the selection and interview process must be adapted to prospectively identify those candidates who can thrive in this changing role. Behavior-based interviewing is a tool that can help identify those candidates who may excel in the future. 1-3 Though there are reports of it being used in the United States medical schools and residency programs across the nation, it has not become a mainstay for medical residency and professional medical interviewing. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Competency frameworks for advanced practice nursing: a literature review.

    PubMed

    Sastre-Fullana, P; De Pedro-Gómez, J E; Bennasar-Veny, M; Serrano-Gallardo, P; Morales-Asencio, J M

    2014-12-01

    This paper describes a literature review that identified common traits in advanced practice nursing that are specific to competency development worldwide. There is a lack of international agreement on the definition of advanced practice nursing and its core competencies. Despite the lack of consensus, there is an ongoing process worldwide to establish and outline the standards and competencies for advanced practice nursing roles. International agencies, such as the International Council of Nurses, have provided general definitions for advanced practice nursing. Additionally, a set of competency standards for this aim has been developed. A literature review and a directed search of institutional websites were performed to identify specific developments in advanced practice nursing competencies and standards of practice. To determine a competency map specific to international advanced practice nursing, key documents were analysed using a qualitative approach based on content analysis to identify common traits among documents and countries. The review process identified 119 relevant journal articles related to advanced practice nursing competencies. Additionally, 97 documents from grey literature that were related to advanced practice nursing competency mapping were identified. From the text analysis, 17 worldwide transversal competency domains emerged. Despite the variety of patterns in international advanced practice nursing development, essential competency domains can be found in most national frameworks for the role development of international advanced practice nursing. These 17 core competencies can be used to further develop instruments that assess the perceived competency of advanced practice nurses. The results of this review can help policy developers and researchers develop instruments to compare advanced practice nursing services in various contexts and to examine their association with related outcomes. © 2014 International Council of Nurses.

  10. Parental attitudes and social competence in adolescents.

    PubMed

    Drózdz, E; Pokorski, M

    2007-11-01

    The aim of the study was to evaluate the relationships among perceived parental attitudes and domains of social competence in late adolescents. Forty boys and 40 girls, all aged 18, representing a population sample of high school second graders were examined. Self-report data were collected using questionnaires of parent-child relations and of social competence. Analyses detected a significant association between the maternal loving or protective attitude and competence in interpersonal relations in the combined sample of adolescents. However, gender was a moderator of this general relationship. Maternal control fostered their sons' interpersonal relations, and no such relationship was observed toward daughters. Adolescents' behavior was somehow less influenced by fatherly control. The findings are in line with the concept of familism as a dominant form of family organization, but implicate constraints in parental sentiments whose overly expression may backfire and do more harm than good in other domains of social competence of adolescents, such as assertiveness and performance during social exposure. The study may contribute to future research on how parenting style shapes adolescent social outcomes.

  11. Water Treatment Technology - General Plant Operation.

    ERIC Educational Resources Information Center

    Ross-Harrington, Melinda; Kincaid, G. David

    One of twelve water treatment technology units, this student manual on general plant operations provides instructional materials for seven competencies. (The twelve units are designed for a continuing education training course for public water supply operators.) The competencies focus on the following areas: water supply regulations, water plant…

  12. Gender Competence of the Modern Teacher

    ERIC Educational Resources Information Center

    Auhadeeva, Ludmila A.; Yarmakeev, Iskander E.; Aukhadeev, Aver E.

    2015-01-01

    This article discusses improvements in education and modern teacher's gender training in terms of a competence-based approach as a basic strategy of general and vocational education development in Russia. The article substantiates the relevance of teachers' gender training and the necessity to use the gender approach in their professional…

  13. A review and critique of some models used in competing risk analysis.

    PubMed

    Gail, M

    1975-03-01

    We have introduced a notation which allows one to define competing risk models easily and to examine underlying assumptions. We have treated the actuarial model for competing risk in detail, comparing it with other models and giving useful variance formulae both for the case when times of death are available and for the case when they are not. The generality of these methods is illustrated by an example treating two dependent competing risks.

  14. The family medicine curriculum resource project structural framework.

    PubMed

    Stearns, Jeffrey A; Stearns, Marjorie A; Davis, Ardis K; Chessman, Alexander W

    2007-01-01

    In the original contract for the Family Medicine Curricular Resource Project (FMCRP), the Health Resources and Services Administration (HRSA), Division of Medicine and Dentistry, charged the FMCRP executive committee with reviewing recent medical education reform proposals and relevant recent curricula to develop an analytical framework for the project. The FMCRP executive and advisory committees engaged in a review and analysis of a variety of curricular reform proposals generated during the last decade of the 20th century. At the same time, in a separate and parallel process, representative individuals from all the family medicine organizations, all levels of learners, internal medicine and pediatric faculty, and the national associations of medical and osteopathic colleges (Association of American Medical Colleges and the American Association of Colleges of Osteopathic Medicine) were involved in group discussions to identify educational needs for physicians practicing in the 21st century. After deliberation, a theoretical framework was chosen for this undergraduate medical education resource that mirrors the Accreditation Council for Graduate Medical Education (ACGME) competencies, a conceptual design originated for graduate medical education. In addition to reflecting the current environment calling for change and greater accountability in medical education, use of the ACGME competencies as the theoretical framework for the FMCR provides a continuum of focus between the two major segments of physician education: medical school and residency.

  15. Using competences and competence tools in workforce development.

    PubMed

    Green, Tess; Dickerson, Claire; Blass, Eddie

    The NHS Knowledge and Skills Framework (KSF) has been a driving force in the move to competence-based workforce development in the NHS. Skills for Health has developed national workforce competences that aim to improve behavioural performance, and in turn increase productivity. This article describes five projects established to test Skills for Health national workforce competences, electronic tools and products in different settings in the NHS. Competences and competence tools were used to redesign services, develop job roles, identify skills gaps and develop learning programmes. Reported benefits of the projects included increased clarity and a structured, consistent and standardized approach to workforce development. Findings from the evaluation of the tools were positive in terms of their overall usefulness and provision of related training/support. Reported constraints of using the competences and tools included issues relating to their availability, content and organization. It is recognized that a highly skilled and flexible workforce is important to the delivery of high-quality health care. These projects suggest that Skills for Health competences can be used as a 'common currency' in workforce development in the UK health sector. This would support the need to adapt rapidly to changing service needs.

  16. Competency-Based Education in Low Resource Settings: Development of a Novel Surgical Training Program.

    PubMed

    McCullough, Meghan; Campbell, Alex; Siu, Armando; Durnwald, Libby; Kumar, Shubha; Magee, William P; Swanson, Jordan

    2018-03-01

    The unmet burden of surgical disease represents a major global health concern, and a lack of trained providers is a critical component of the inadequacy of surgical care worldwide. Competency-based training has been advanced in high-income countries, improving technical skills and decreasing training time, but it is poorly understood how this model might be applied to low- and middle-income countries. We describe the development of a competency-based program to accelerate specialty training of in-country providers in cleft surgery techniques. The program was designed and piloted among eight trainees at five international cleft lip and palate surgical mission sites in Latin America and Africa. A competency-based evaluation form, designed for the program, was utilized to grade general technical and procedure-specific competencies, and pre- and post-training scores were analyzed using a paired t test. Trainees demonstrated improvement in average procedure-specific competency scores for both lip repairs (60.4-71.0%, p < 0.01) and palate (50.6-66.0%, p < 0.01). General technical competency scores also improved (63.6-72.0%, p < 0.01). Among the procedural competencies assessed, surgical markings showed the greatest improvement (19.0 and 22.8% for lip and palate, respectively), followed by nasal floor/mucosal approximation (15.0%) and hard palate dissection (17.1%). Surgical delivery models in LMICs are varied, and trade-offs often exist between goals of case throughput, quality and training. Pilot program results show that procedure-specific and general technical competencies can be improved over a relatively short time and demonstrate the feasibility of incorporating such a training program into surgical outreach missions.

  17. Analysis Influence of Managerial Competence, Technical Competence, and Strategic Competence on Firm Performance in Electrical Engineering Company in Bandung

    NASA Astrophysics Data System (ADS)

    Wijaya, E. R.; Irianto, D.

    2018-03-01

    The industry sectors that have an important role in the era of globalization is the electro engineering sector. The era of globalization led to intense competition. One of the negative effects of the intense competition is declining profits. Drop in profits caused many firms reduces their employees without seeking the root cause of declining profits in detail. Whereas, employee is the important resources to maintain competitive advantage. Competitive advantage can be measured by the performance of which is owned by the firm. The firm's performance can be formed of competencies that is unique, rare, irreplaceable, and difficult to imitate within the firm, one of them is the competence of the individual. According to a competency-based approach and the resource- based approach, individual competence that affect the performance of the firm is managerial competence, technical competence, and strategic competence. Questionnaire is built based on the dimensions of the firm's performance, managerial competence, technical competence, and strategic competence, are processed using partial least squares application. The results indicate that managerial competence negatively impact firm’s performance with weak ties. The technical competence and strategic competence positively affect firm’s performance with moderate ties.

  18. Developing competencies for medical librarians in Pakistan.

    PubMed

    Ullah, Midrar; Anwar, Mumtaz A

    2013-03-01

    To identify competencies for medical librarians and get these validated from head librarians and employers. The survey method was used. A structured questionnaire, listing 84 competency statements, covering eight areas, prepared after extensive literature review, expert scrutiny and pilot testing, using a 5-point Likert scale was distributed among the head librarians and chairpersons of library committees (CLC) in 115 medical libraries. Sixty seven (58%) useable responses were received from head librarians and 63 (55%) from CLC. Of the 84 competency statements 83 were validated by the head librarians, 44 receiving four or higher mean score while the other 39 statements getting mean scores in the range of 3.97 and 3.06. The CLC validated 80 statements. Only 27 statements received four or higher mean score from CLC while the other 53 got mean scores in the range of 3.97 and 3.22. Medical librarians are required to be well versed with all those competencies which are needed for general librarianship. In addition, they are expected to have adequate knowledge of health sciences environment including medical terminologies and concepts. Sound knowledge of some competencies specific for medical libraries is an additional requirement for library personnel. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

  19. Assessing Pharmacy Students’ Self-Perception of Cultural Competence

    PubMed Central

    Echeverri, Margarita; Brookover, Cecile; Kennedy, Kathleen

    2014-01-01

    Pharmacists play an increasingly important role in medication therapy management, which requires communicating effectively with patients. Pharmacy students completed the Self-Assessment of Perceived Level of Cultural Competence (SAPLCC) questionnaire, and their results were used to identify patterns in self-assessment of cultural competence. In general, students rated their knowledge as less than their skills and attitudes. Important differences were found by race, comparing each group with its counterparts: African American students rated their perceived competencies regarding patient discrimination and barriers to health care at a significantly higher level; Asian American students rated their attitudes to engaging in self-reflection and their knowledge in multicultural issues at significantly lower level; and White students rated their awareness regarding racial dynamics at a significantly lower level. It is recommended to consider the students’ cultural, racial, and ethnic backgrounds before developing curriculum in cultural competence and, perhaps, to develop targeted educational interventions for specific groups. PMID:23395945

  20. Competency Analytics Tool: Analyzing Curriculum Using Course Competencies

    ERIC Educational Resources Information Center

    Gottipati, Swapna; Shankararaman, Venky

    2018-01-01

    The applications of learning outcomes and competency frameworks have brought better clarity to engineering programs in many universities. Several frameworks have been proposed to integrate outcomes and competencies into course design, delivery and assessment. However, in many cases, competencies are course-specific and their overall impact on the…

  1. Constructing a competency-based bariatric surgery fellowship training curriculum.

    PubMed

    McBride, Corrigan L; Rosenthal, Raul J; Brethauer, Stacy; DeMaria, Eric; Kelly, John J; Morton, John M; Lo Menzo, Emanuele; Moore, Rachel; Pomp, Alfons; Nguyen, Ninh T

    2017-03-01

    Bariatric fellowship training after general surgery has historically been time based and competence was determined at completion based on a minimum number of cases during the fellowship. Graduate medical education is moving toward competency-based medical education where learners are evaluated during the course of their training and competence assessment occurs throughout. The Executive Council of the American Society of Metabolic and Bariatric Surgery (ASMBS) at the direction of the American Board of Surgery wanted to transition the bariatric surgery fellowship curriculum from its traditional format to a competency-based curriculum using competency-based medical education principles. The ASMBS Education and Training Committee established a task force of 9 members to create a new curriculum and all of the necessary evaluation tools to support the curriculum, and initiate a pilot program. A competency-based curriculum consisting of 6 modules with cognitive and technical milestones, and the innovative evaluation tools needed to evaluate the learners, was created. A pilot program consisting of 10 programs and 19 fellows has been undertaken for the 2016-2017 academic year. The Education Committee of the ASMBS is leading the charge in curriculum development for competency-based medical education for bariatric fellowship. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  2. Reproductive competence: a recurrent logic module in eukaryotic development

    PubMed Central

    Noble, Luke M.; Andrianopoulos, Alex

    2013-01-01

    Developmental competence is the ability to differentiate in response to an appropriate stimulus, as first elaborated by Waddington in relation to organs and tissues. Competence thresholds operate at all levels of biological systems from the molecular (e.g. the cell cycle) to the ontological (e.g. metamorphosis and reproduction). Reproductive competence, an organismal process, is well studied in mammals (sexual maturity) and plants (vegetative phase change), though far less than later stages of terminal differentiation. The phenomenon has also been documented in multiple species of multicellular fungi, mostly in early, disparate literature, providing a clear example of physiological differentiation in the absence of morphological change. This review brings together data on reproductive competence in Ascomycete fungi, particularly the model filamentous fungus Aspergillus nidulans, contrasting mechanisms within Unikonts and plants. We posit reproductive competence is an elementary logic module necessary for coordinated development of multicellular organisms or functional units. This includes unitary multicellular life as well as colonial species both unicellular and multicellular (e.g. social insects such as ants). We discuss adaptive hypotheses for developmental and reproductive competence systems and suggest experimental work to address the evolutionary origins, generality and genetic basis of competence in the fungal kingdom. PMID:23864594

  3. Evaluations of refraction competencies of ophthalmic technicians in Mozambique.

    PubMed

    Shah, Kajal; Naidoo, Kovin; Chagunda, Margarida; Loughman, James

    2016-01-01

    Ophthalmic technicians (OT) work at health facilities in Mozambique and are trained to provide primary and secondary eye care services including basic refraction. This study was designed to assess OT competence and confidence in refraction, and investigate whether an upskilling programme is effective in developing their competence and confidence at refraction. Thirty-one trainee OTs and 16 qualified OTs were recruited to the study. A background questionnaire was administered to determine the demographic profile of the OTs. A confidence levels questionnaire explored their self-reported skills. Clinical competencies were assessed in relation to knowledge (theory exam) and clinical skills (patient exams). 11 OTs were upskilled and the clinical evaluations carried out post training. Initial evaluations demonstrated that confidence and competence levels varied depending on the OTs training (location and duration), and their location of work (clinical load, availability of equipment and other eye care personnel). The qualified OTs were more competent than trainee OTs in most of the evaluations. Post upskilling results demonstrated significant positive impact on confidence and competence levels. These evaluations identified factors affecting the refraction competencies of the OTs and demonstrated that upskilling is effective in improving confidence and competence levels for refraction. They demonstrate the need for a refraction competency framework. The overarching aim of this research was to inform the development of a nationwide programme of OT mentoring, upskilling and leading to the establishment of clinical competency standards for the new OT curricula, relevant to the professional demands. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  4. Measures of cultural competence: examining hidden assumptions.

    PubMed

    Kumaş-Tan, Zofia; Beagan, Brenda; Loppie, Charlotte; MacLeod, Anna; Frank, Blye

    2007-06-01

    The authors critically examined the quantitative measures of cultural competence most commonly used in medicine and in the health professions, to identify underlying assumptions about what constitutes competent practice across social and cultural diversity. A systematic review of approximately 20 years of literature listed in PubMed, the Cumulative Index of Nursing and Allied Health Literature, Social Services Abstracts, and the Educational Resources Information Center identified the most frequently used cultural competence measures, which were then thematically analyzed following a structured analytic guide. Fifty-four instruments were identified; the 10 most widely used were analyzed closely, identifying six prominent assumptions embedded in the measures. In general, these instruments equate culture with ethnicity and race and conceptualize culture as an attribute possessed by the ethnic or racialized Other. Cultural incompetence is presumed to arise from a lack of exposure to and knowledge of the Other, and also from individual biases, prejudices, and acts of discrimination. Many instruments assume that practitioners are white and Western and that greater confidence and comfort among practitioners signify increased cultural competence. Existing measures embed highly problematic assumptions about what constitutes cultural competence. They ignore the power relations of social inequality and assume that individual knowledge and self-confidence are sufficient for change. Developing measures that assess cultural humility and/or assess actual practice are needed if educators in the health professions and health professionals are to move forward in efforts to understand, teach, practice, and evaluate cultural competence.

  5. Surgical residents' perception of competence and relevance of the clinical curriculum to future practice.

    PubMed

    Fronza, Jeffrey Scott; Prystowsky, Jay P; DaRosa, Debra; Fryer, Jonathan P

    2012-01-01

    General surgery residents maintain a case log throughout residency in order to achieve a targeted number of designated operations. Program directors must certify that each graduate is competent to enter general surgery practice without direct supervision. Our purpose was twofold, to determine: 1) graduates' perception of competence and relevance of specific operations to their practice; and 2) if case volume is related to competence. Six classes from a general surgery residency program (n=26) were surveyed one year after graduation. The survey was piloted and revised base on findings. It listed 67 operations encompassing all facets of general surgery. Each operation corresponded to two four-point scales (strongly agree to strongly disagree). One scale was headed with "I was well prepared to work-up, independently perform the operation, and effectively care for the patient post-operatively" and the other "This operation is relevant to my current practice profile". A linear regression analysis was utilized to study the relationship between total case volume and overall competence. An unpaired T-test was utilized to study the relationship between volume of specific operations and perceptions of competence. Twenty-two graduates completed the survey (85% response rate). All respondents felt prepared to perform 24% (16/67) of the operations. Fifty percent or more of respondents felt prepared to perform 91% (61/67) of the operations. Fifty percent or more did not feel competent performing the surgical treatment of necrotizing enterocolitis, orchiopexy, transhiatal esophagectomy, adrenalectomy, and open/endovascular abdominal aortic aneurysm repair. Twenty-six operations were felt to be irrelevant to the practice of 50% or more of graduates. No operation was unanimously felt to be relevant. For 12% of operations (8/67) at least 10% of graduates felt the operation was relevant to their practice but were not comfortable performing it. These operations (abdominoperineal

  6. Developing competencies for pediatric hospice and palliative medicine.

    PubMed

    Klick, Jeffrey C; Friebert, Sarah; Hutton, Nancy; Osenga, Kaci; Pituch, Kenneth J; Vesel, Tamara; Weidner, Norbert; Block, Susan D; Morrison, Laura J

    2014-12-01

    In 2006, hospice and palliative medicine (HPM) became an officially recognized subspecialty. This designation helped initiate the Accreditation Council of Graduate Medical Education Outcomes Project in HPM. As part of this process, a group of expert clinician-educators in HPM defined the initial competency-based outcomes for HPM fellows (General HPM Competencies). Concurrently, these experts recognized and acknowledged that additional expertise in pediatric HPM would ensure that the competencies for pediatric HPM were optimally represented. To fill this gap, a group of pediatric HPM experts used a product development method to define specific Pediatric HPM Competencies. This article describes the development process. With the ongoing evolution of HPM, these competencies will evolve. As part of the Next Accreditation System, the Accreditation Council of Graduate Medical Education uses milestones as a framework to better define competency-based, measurable outcomes for trainees. Currently, there are no milestones specific to HPM, although the field is designing curricular milestones with multispecialty involvement, including pediatrics. These competencies are the conceptual framework for the pediatric content in the HPM milestones. They are specific to the pediatric HPM subspecialist and should be integrated into the training of pediatric HPM subspecialists. They will serve a foundational role in HPM and should inform a wide range of emerging innovations, including the next evolution of HPM Competencies, development of HPM curricular milestones, and training of adult HPM and other pediatric subspecialists. They may also inform pediatric HPM outcome measures, as well as standards of practice and performance for pediatric HPM interdisciplinary teams. Copyright © 2014 by the American Academy of Pediatrics.

  7. Developing a Competency-Based Component for the Connecticut Vocational Agriculture Curriculum. Final Report.

    ERIC Educational Resources Information Center

    EASTCONN Regional Educational Services Center, North Windham, CT.

    Competencies are identified for the four primary instructional areas of the Connecticut Vocational Agriculture Curriculum: plant science, agricultural mechanics, natural resources, and animal science. The competencies for each instructional area are divided into those for exploratory units generally appropriate for instruction at the…

  8. Best practices for assessing competence and performance of the behavioral health workforce.

    PubMed

    Bashook, Philip G

    2005-01-01

    The need for mechanisms to assess the competence and performance of the behavioral health workforce has received increasing attention. This article reviews strategies used in general medicine and other disciplines for assessing trainees and practitioners. The possibilities and limitations of various approaches are reviewed, and the implications for behavioral health are addressed. A conceptual model of competence is presented, and practical applications of this model are reviewed. Finally, guidelines are proposed for building competency assessment protocols for behavioral health.

  9. AAOHN Competencies.

    PubMed

    2015-11-01

    The AAOHN Competency document is one of the core documents that define occupational health nursing practice. This article provides a description of the process used to update the competencies, as well as a description of the new competencies. © 2015 The Author(s).

  10. The relationship between motor competence, physical fitness and self-perception in children.

    PubMed

    Vedul-Kjelsås, V; Sigmundsson, H; Stensdotter, A-K; Haga, M

    2012-05-01

    The aim of the current research was to explore the relationship between motor competence, physical fitness and self-perception, and to study to which extent this relationship may vary by gender. A sample of 67 children (mean age 11.46 years, SD 0.27) completed Harter's Self-Perception Profile for Children (SPPC), the Movement Assessment Battery for Children (MABC) and the Test of Physical Fitness (TPF) to assess self-perception, motor competence and physical fitness. The SPPC was stronger related to total score on TPF than to total score on MABC. However, when looking at boys and girls separately, this result was found for the boys only. In the group in general, total scores on both TPF and MABC correlated significantly with three of the domains of SPPC (social acceptance, athletic competence and physical appearance) and general self-worth. This relationship varied by gender. Interestingly, TPF was highest correlated with perception of athletic competence in boys but with perception of social acceptance in girls. A high and significant correlation was found between physical fitness and motor competence for both genders. The results indicated a strong relationship between physical fitness, motor competence and self-perception in children that varied by gender. This implies that all these factors are essential contributions in order to facilitate participation in physical activity in children. © 2011 Blackwell Publishing Ltd.

  11. An overview of the competency movement in nursing and midwifery.

    PubMed

    Chiarella, Mary; Thoms, Debra; Lau, Cecilia; McInnes, Elizabeth

    2008-01-01

    The aim of this paper is to examine the purpose and growth of the development of general, advanced and specialist competency standards in nursing and midwifery in Australia. The definitions, content, types, utility and acceptability of competencies are reviewed. This paper also reports the results of a recent survey of nurses and midwives about the uses of competency standards. Challenges in identifying and assessing the impact of competency standards on practice and professional development; reasons for their proliferation and associated shortcomings such as their lack of cultural sensitivity and inability to reflect the complexity of nursing care are also explored. The rationale for this paper is that charting these issues and identifying gaps in the field will assist the further development and refinement of competency frameworks for Australian nursing. The paper concludes by recommending that future research in this area should focus on: (1) formal analysis of the validity and suitability of competency standards in relation to the purposes for which they are designed; (2) the mapping of competency domains, elements and performance criteria to identify similarities and differences in order to provide insight into the nature of both specialist and advanced practice nursing; and (3) a systematic review of the competency literature to ascertain the level of evidence that exists to support the use of competencies in terms of standard setting, safe practice and enhancement of patient outcomes.

  12. Learning Analytics for 21st Century Competencies

    ERIC Educational Resources Information Center

    Buckingham Shum, Simon; Crick, Ruth Deakin

    2016-01-01

    Many educational institutions are shifting their teaching and learning towards equipping students with knowledge, skills, and dispositions that prepare them for lifelong learning, in a complex and uncertain world. These have been termed "21st century competencies." Learning analytics (LA) approaches in general offer different kinds of…

  13. Cultural competence in medical education: A questionnaire study of Danish medical teachers' perceptions of and preparedness to teach cultural competence.

    PubMed

    Sorensen, Janne; Jervelund, Signe Smith; Norredam, Marie; Kristiansen, Maria; Krasnik, Allan

    2017-03-01

    The cultural competence training of healthcare professionals is a key element in ensuring the quality of both the access and delivery of healthcare to increasingly ethnically diverse populations. The aim of this study is to investigate Danish medical teachers' opinions about cultural competence, their willingness to receive training and preparedness to teach cultural competence topics. The survey was sent to medical teachers, clinical teachers and external lecturers who teach in the medical programme at the University of Copenhagen. A total of 1400 medical teachers received the survey, and 199 responded. The response rate is 14%. Data were analysed through descriptive calculations, and answers to open-ended questions were coded using content analysis. Results showed that 82.4% of the informants agreed or strongly agreed that the medical education programme should include training on cultural issues, and 60.3% agreed or strongly agreed that students should be assessed on their cultural competence skills. Regarding preparedness to teach a diverse classroom, 88.4% felt somewhat or very prepared to engage and motivate all students. About 70% were interested in receiving training on cultural competence. Generally, there is interest in and acknowledgement of the importance of cultural competence in Danish medical education among teachers at the University of Copenhagen. This creates an opportunity to implement cultural competence in the medical curriculum, training of teachers and strengthening the diversity sensitivity of the organisation. However, support for this programme by management and the allocation of an appropriate level of resources is a prerequisite to the success of the programme.

  14. International Nursing: Nurse Managers' Leadership and Management Competencies Assessed by Nursing Personnel in a Finnish Hospital.

    PubMed

    Lehtonen, Mia-Riitta; Roos, Mervi; Kantanen, Kati; Suominen, Tarja

    The aim of this research was to describe nurse managers' leadership and management competencies (NMLMC) from the perspective of nursing personnel. Nurse managers are responsible for the management of the largest professional group in social and health care. The assessment of NMLMC is needed because of their powerful influence on organizational effectiveness. An electronic survey was conducted among the nursing personnel (n = 166) of 1 Finnish hospital in spring 2016. Nursing personnel assessed their manager using a NMLMC scale consisting of general and special competences. The data were statistically analyzed. Leadership and management competencies were assessed as being quite good by the nursing personnel. The best-assessed area of general competence was professional competence and credibility and the weakest was service initiation and innovation. The best-assessed area of special competence was substance knowledge and the weakest was research and development. The nursing personnel's assessment of their nurse manger's competencies was associated with the personnel's education level, working experience, and with their knowledge of the manager's education. Conclusion was made that nursing personnel highly value professional competence as part of nursing leadership and management. To achieve more appreciation, nurse managers have to demonstrate their education and competence. They must also work in more open and versatile ways with their nursing personnel.

  15. Rheumatology training experience across Europe: analysis of core competences.

    PubMed

    Sivera, Francisca; Ramiro, Sofia; Cikes, Nada; Cutolo, Maurizio; Dougados, Maxime; Gossec, Laure; Kvien, Tore K; Lundberg, Ingrid E; Mandl, Peter; Moorthy, Arumugam; Panchal, Sonia; da Silva, José A P; Bijlsma, Johannes W

    2016-09-23

    The aim of this project was to analyze and compare the educational experience in rheumatology specialty training programs across European countries, with a focus on self-reported ability. An electronic survey was designed to assess the training experience in terms of self-reported ability, existence of formal education, number of patients managed and assessments performed during rheumatology training in 21 core competences including managing specific diseases, generic competences and procedures. The target population consisted of rheumatology trainees and recently certified rheumatologists across Europe. The relationship between the country of training and the self-reported ability or training methods for each competence was analyzed through linear or logistic regression, as appropriate. In total 1079 questionnaires from 41 countries were gathered. Self-reported ability was high for most competences, range 7.5-9.4 (0-10 scale) for clinical competences, 5.8-9.0 for technical procedures and 7.8-8.9 for generic competences. Competences with lower self-reported ability included managing patients with vasculitis, identifying crystals and performing an ultrasound. Between 53 and 91 % of the trainees received formal education and between 7 and 61 % of the trainees reported limited practical experience (managing ≤10 patients) in each competence. Evaluation of each competence was reported by 29-60 % of the respondents. In adjusted multivariable analysis, the country of training was associated with significant differences in self-reported ability for all individual competences. Even though self-reported ability is generally high, there are significant differences amongst European countries, including differences in the learning structure and assessment of competences. This suggests that educational outcomes may also differ. Efforts to promote European harmonization in rheumatology training should be encouraged and supported.

  16. Cogenerating a Competency-based HRM Degree: A Model and Some Lessons from Experience.

    ERIC Educational Resources Information Center

    Wooten, Kevin C.; Elden, Max

    2001-01-01

    A competency-based degree program in human resource management was co-generated by six groups of stakeholders who synthesized competency models using group decision support software. The program focuses on core human resource processes, general business management, strategic decision making and problem solving, change management, and personal…

  17. Threat-Related Information Suggests Competence: A Possible Factor in the Spread of Rumors

    PubMed Central

    Boyer, Pascal; Parren, Nora

    2015-01-01

    Information about potential danger is a central component of many rumors, urban legends, ritual prescriptions, religious prohibitions and witchcraft crazes. We investigate a potential factor in the cultural success of such material, namely that a source of threat-related information may be intuitively judged as more competent than a source that does not convey such information. In five studies, we asked participants to judge which of two sources of information, only one of which conveyed threat-related information, was more knowledgeable. Results suggest that mention of potential danger makes a source appear more competent than others, that the effect is not due to a general negativity bias, and that it concerns competence rather than a more generally positive evaluation of the source. PMID:26061409

  18. Competence skills help deter smoking among inner city adolescents.

    PubMed

    Epstein, J A; Griffin, K W; Botvin, G J

    2000-03-01

    To test whether higher levels of general competence are linked to more frequent use of refusal assertiveness that is in turn related to less subsequent smoking among inner city adolescents. Longitudinal study conducted during three year middle school or junior high school period. A sample of 1459 students attending 22 middle (ages 11-14 years) and junior high (ages 12-15 years) schools in New York City participated. Students completed surveys at baseline, one year follow up, and two year follow up. The students self reported smoking, decision making skills, personal efficacy, and refusal assertiveness. Teams of three to five data collectors administered the questionnaire following a standardised protocol. These data were collected in school during a regular 40 minute class period. Based on the tested structural equation model, decision making and personal efficacy (that is, general competence) predicted higher refusal assertiveness and this greater assertiveness predicted less smoking at the two year follow up. The tested model had a good fit and was parsimonious and consistent with theory. Adolescent smoking prevention programmes often teach refusal skills in order to help youth resist peer pressure to smoke. The present findings suggest that teaching general competence skills as well may help to reduce smoking because youth with better personal efficacy and decision making skills are better able to implement smoking refusal strategies.

  19. Croatian Teacher Competencies Related to the Creation and Implementation of Education Policy

    ERIC Educational Resources Information Center

    Kovac, Vesna; Rafajac, Branko; Buchberger, Iva

    2014-01-01

    This research was conducted in order to gain a preliminary insight into the general orientation and range of opinions of 396 primary and secondary school teachers in Croatia toward the a) importance of their competencies related to the education policies; b) cognition and mastering of the competencies related to the education policies; c) the…

  20. Self-Organization of Light in Optical Media with Competing Nonlinearities.

    PubMed

    Maucher, F; Pohl, T; Skupin, S; Krolikowski, W

    2016-04-22

    We study the propagation of light beams through optical media with competing nonlocal nonlinearities. We demonstrate that the nonlocality of competing focusing and defocusing nonlinearities gives rise to self-organization and stationary states with stable hexagonal intensity patterns, akin to transverse crystals of light filaments. Signatures of this long-range ordering are shown to be observable in the propagation of light in optical waveguides and even in free space. We consider a specific form of the nonlinear response that arises in atomic vapor upon proper light coupling. Yet, the general phenomenon of self-organization is a generic consequence of competing nonlocal nonlinearities, and may, hence, also be observed in other settings.

  1. Competency champions in the clinical competency committee: a successful strategy to implement milestone evaluations and competency coaching.

    PubMed

    Ketteler, Erika R; Auyang, Edward D; Beard, Kathy E; McBride, Erica L; McKee, Rohini; Russell, John C; Szoka, Nova L; Nelson, M Timothy

    2014-01-01

    To create a clinical competency committee (CCC) that (1) centers on the competency-based milestones, (2) is simple to implement, (3) creates competency expertise, and (4) guides remediation and coaching of residents who are not progressing in milestone performance evaluations. We created a CCC that meets monthly and at each meeting reviews a resident class for milestone performance, a competency (by a faculty competency champion), a resident rotation service, and any other resident or issue of concern. University surgical residency program. The CCC members include the program director, associate program directors, director of surgical curriculum, competency champions, departmental chair, 2 at-large faculty members, and the administrative chief residents. Seven residents were placed on remediation (later renamed as coaching) during the academic year after falling behind on milestone progression in one or more competencies. An additional 4 residents voluntarily placed themselves on remediation for medical knowledge after receiving in-training examination scores that the residents (not the CCC membership) considered substandard. All but 2 of the remediated/coached residents successfully completed all area milestone performance but some chose to stay on the medical knowledge competency strategy. Monthly meetings of the CCC make milestone evaluation less burdensome. In addition, the expectations of the residents are clearer and more tangible. "Competency champions" who are familiar with the milestones allow effective coaching strategies and documentation of clear performance improvements in competencies for successful completion of residency training. Residents who do not reach appropriate milestone performance can then be placed in remediation for more formal performance evaluation. The function of our CCC has also allowed us opportunity to evaluate the required rotations to ensure that they offer experiences that help residents achieve competency performance necessary

  2. Noncontingent reinforcement competes with response performance.

    PubMed

    Kelley, Michael E; Nadler, Cy B; Rey, Catalina; Cowie, Sarah; Podlesnik, Christopher A

    2017-05-01

    Noncontingent reinforcement is a commonly used procedure to decrease levels of problem behavior. Goals of this intervention are to decrease motivation, responding, and the functional relation between behavior and consequences, but it could also possibly compete with performance of alternative desirable responses. In the current study, we assessed the effects of noncontingent reinforcement arranged from 0% to 100% of sessions on performance of alternative responding across two experiments. Experiment 1 assessed manding (i.e., requests) maintained by attention and tangibles with a child with developmental disabilities and Experiment 2 assessed keypecking maintained by food with six pigeons. We extended previous research by (a) showing that noncontingent reinforcement competes with both the acquisition and maintenance (performance) of an alternative response, (b) extending the generality of the findings across nonhuman and human participants, and (c) eliminating influence of sequence effects through random manipulations of noncontingent value in pigeons. Overall, greater amounts of noncontingent reinforcement competed with both acquisition and maintenance of alternative responding. © 2017 Society for the Experimental Analysis of Behavior.

  3. Semi-Competing Risks Data Analysis: Accounting for Death as a Competing Risk When the Outcome of Interest Is Nonterminal.

    PubMed

    Haneuse, Sebastien; Lee, Kyu Ha

    2016-05-01

    Hospital readmission is a key marker of quality of health care. Notwithstanding its widespread use, however, it remains controversial in part because statistical methods used to analyze readmission, primarily logistic regression and related models, may not appropriately account for patients who die before experiencing a readmission event within the time frame of interest. Toward resolving this, we describe and illustrate the semi-competing risks framework, which refers to the general setting where scientific interest lies with some nonterminal event (eg, readmission), the occurrence of which is subject to a terminal event (eg, death). Although several statistical analysis methods have been proposed for semi-competing risks data, we describe in detail the use of illness-death models primarily because of their relation to well-known methods for survival analysis and the availability of software. We also describe and consider in detail several existing approaches that could, in principle, be used to analyze semi-competing risks data, including composite end point and competing risks analyses. Throughout we illustrate the ideas and methods using data on N=49 763 Medicare beneficiaries hospitalized between 2011 and 2013 with a principle discharge diagnosis of heart failure. © 2016 American Heart Association, Inc.

  4. EVATS: a proactive solution to improve surgical education and maintain flexibility in the new training era.

    PubMed

    Horvath, Karen D; Mann, Gary N; Pellegrini, Carlos

    2006-01-01

    To describe the development of the EVATS rotation. Descriptive document. University teaching hospital. Faculty and residents of the University of Washington. In July 2003 we identified the need for a new, independent, educational module within our residency training. Requirements for this rotation included dedicated time for technical skills training on simulators, independent competency learning modules, academic research project time, vacation time and coverage, and flexibility for unplanned leave (eg, interview travel, m/paternity leave). An EVATS rotation was created in July 2003 that is provided at each training level and lasts from 4 to 8 weeks depending on R-level. EVATS meets the following challenges: Emergency coverage (EVATS residents available for last-minute service coverage), vacation time/vacation coverage (2 weeks vacation + 1 week vacation coverage; this maintains vacations for all residents every 6 months), academic time (residents now must complete 1 academic project for graduation) and ACGME competency learning and assessment, and technical skills training (includes simulator work for open/lap skills). Initial implementation indices are high and include resident satisfaction, 80-hour work week compliance, academic productivity, and patient continuity of care. The 21st century brought new challenges for surgical training. Increased societal demands for skills training in a laboratory setting using simulators and the 6 ACGME competencies all require classroom-type training periods. Paradoxically, the 80-hour work week restricted the time available for these educational activities and made it more difficult for programs to accommodate resident vacations and emergencies. These challenges provided an opportunity to enhance the educational experience for our residency program. The product was the EVATS rotation. Early data after implementation are favorable.

  5. Moral competency: meta-competence of nursing care

    PubMed Central

    Zafarnia, Niloofar; Abbaszadeh, Abbas; Borhani, Fariba; Ebadi, Abbas; Nakhaee, Nouzar

    2017-01-01

    Introduction To follow the progress of technology and increasing domain of nurses’ duties, ethical challenges can be observed more than ever. Therefore, the growing and dynamic system of nursing requires nurses with professional and ethical competence who can provide optimal care. The aim of the present study was to define and explain dimensions of moral competency among the clinical nurses of Iran. Methods This qualitative content analysis study was carried out in the years 2014 and 2015 in Iran. Data were collected through in-depth semistructured interviews and field notes. The resulting data were analyzed by Graneheim and Lundman’s method of conventional content analysis. The participants were 12 clinical nurses who were selected using purposive convenient sampling and continued interviews until data saturation. Results Themes obtained in the present study were posited in three main categories of “moral character,” with subcategories of altruism, search for meaning, be pioneering, perfectionism, self-control, honesty, and forgiveness; “moral care” with subcategories of dignified care, safe care, fair care, and holistic care; and “moral decision-making” with subcategories of moral sensitivity, moral thinking, moral reasoning, and moral courage. Conclusions Findings of the present study suggest that nurses’ moral competency is an adorable character with a wide range that includes moral virtues and character, moral decision-making, and ultimately providing moral care; therefore, moral competency is a meta-competence in the field of nursing. Because there are many competencies in different fields. PMID:28848630

  6. A window of opportunity? Motor skills and perceptions of competence of children in Kindergarten

    PubMed Central

    2012-01-01

    Background Our aim was to examine the relationship between motor skill proficiency and perceptions of competence of children in their first year of school. We also explored gender-based differences. Findings Participants were 260 kindergarten children (mean age = 5y 9 m; boys = 52%) from eight schools; representing 78% of eligible children in those schools. Motor skills were measured using the Test of Gross Motor Development-2 and perceptions of physical competence were assessed using the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children. Motor skill scores were generally low (percentile ranks ranged from 16 - 24) but perceptions of physical competence were positive (boys = 18.1/24.0, girls = 19.5/24.0). A MANOVA showed a significant overall effect for gender (Wilk's lambda = .84 with F (3, 254) = 15.84, p < 0.001) and univariate F tests were significant for all outcome variables. The relationship between object control skills and perceptions of physical competence among girls was not significant; however all other correlations were modest but significant. Conclusions Although motor skill levels were quite low, the children generally held positive perceptions of their physical competence. These positive perceptions provide a window of opportunity for fostering skillfulness. The modest relationships between perceptions of competence and motor skill proficiency suggest that the children are beginning to make self-judgments at a young age. Accordingly, opportunities for children to become and feel physically competent need to occur early in their school or preschool life. PMID:22420534

  7. A window of opportunity? Motor skills and perceptions of competence of children in kindergarten.

    PubMed

    LeGear, Mark; Greyling, Lizette; Sloan, Erin; Bell, Rick I; Williams, Buffy-Lynne; Naylor, Patti-Jean; Temple, Viviene A

    2012-03-15

    Our aim was to examine the relationship between motor skill proficiency and perceptions of competence of children in their first year of school. We also explored gender-based differences. Participants were 260 kindergarten children (mean age = 5y 9 m; boys = 52%) from eight schools; representing 78% of eligible children in those schools. Motor skills were measured using the Test of Gross Motor Development-2 and perceptions of physical competence were assessed using the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children. Motor skill scores were generally low (percentile ranks ranged from 16 - 24) but perceptions of physical competence were positive (boys = 18.1/24.0, girls = 19.5/24.0). A MANOVA showed a significant overall effect for gender (Wilk's lambda = .84 with F (3, 254) = 15.84, p < 0.001) and univariate F tests were significant for all outcome variables. The relationship between object control skills and perceptions of physical competence among girls was not significant; however all other correlations were modest but significant. Although motor skill levels were quite low, the children generally held positive perceptions of their physical competence. These positive perceptions provide a window of opportunity for fostering skillfulness. The modest relationships between perceptions of competence and motor skill proficiency suggest that the children are beginning to make self-judgments at a young age. Accordingly, opportunities for children to become and feel physically competent need to occur early in their school or preschool life.

  8. Perceived competence in children and adolescents with haemophilia: an explorative study.

    PubMed

    Hegeman, A K; Van Genderen, F R; Meijer, S; Van Den Briel, M M; Tamminga, R Y J; Van Weert, E

    2011-01-01

    With the introduction of prophylaxis, restricting children with haemophilia to participate in physical activities was no longer necessary. Subsequently, many studies report on improved physical functioning in children and adolescents with haemophilia. However, little is known about psychological aspects such as perceived competence and impact of disease. Therefore, the aims of this study were to explore: (i) perceived competence, (ii) perceived impact of illness, and (iii) analyse associations between perceived competence and demographic factors, disease-related factors and joint status in young haemophiliacs in the Netherlands. Fifty-four children (age 8-12 years) and 72 adolescents (12-18 years) with haemophilia participated in this cross-sectional, multi-centre, explorative study. Measurements included perceived competence (Self Perception Profile for Children/Adolescents; range 6-24/5-20), impact of disease (Revised Perception Illness Experience; range 1-5), demographic factors, disease-related factors, joint status and functional status. Mean (SD) scores for perceived competence in the children ranged from 17.3 (±4.0) to 19.6 (±4.0), and for adolescents from 13.3 (±2.4) to 15.7 (±2.8) points. In general, scores were comparable with those of healthy peers, but children with haemophilia had a lower global self-worth score and competence in close friendship was lower for adolescents when compared with those of healthy peers. Mean (SD) scores for impact of disease ranged from 1.2 (±0.4) to 2.3 (±0.8) in children and from 1.3 (±0.4) to 2.0 (±0.8) in adolescents. Severe haemophilia, prophylactic medication, high impact of disease and a shorter walking distance showed a weak to moderate association with perceived competence. Children and adolescents with haemophilia in general have a perceived competence that is nearly comparable with that of healthy peers, with the exception of a lower global self-worth in children and a lower competence for close friendship

  9. Development of a competency framework for the nutrition in emergencies sector.

    PubMed

    Meeker, Jessica; Perry, Abigail; Dolan, Carmel; Emary, Colleen; Golden, Kate; Abla, Caroline; Walsh, Anne; Maclaine, Ali; Seal, Andrew

    2014-03-01

    There is a recognised need to strengthen capacity in the nutrition in emergencies sector and for greater clarity on the role of emergency nutritionists and the skills they require. Competency frameworks are an important tool for human resource development and have been developed for several other humanitarian sectors. We therefore developed a technical competency framework for practitioners in nutrition in emergencies. Existing competency frameworks were reviewed and interviews conducted to explore methods used in developing competency frameworks for other sectors. Competencies were identified through interviews with field experts, feedback from course trainees, academic course content and job specifications. Competencies were then categorised and behavioural indicators developed for each. The draft framework was then reviewed by members of the Global Nutrition Cluster and modified in an iterative process. Global. Not applicable. A wide range of competencies were identified as essential for nutritionists working in emergencies, covering technical skills and general core competencies. The proposed framework contains twenty competency areas with 161 behavioural indicators categorised into three levels, corresponding to the requirements of progressively more senior roles. Many of the competencies are common across development and emergency nutrition. The proposed technical competency framework should prove to be a valuable tool in creating standards within the sector and promoting effective capacity strengthening and professionalisation. Continued research is needed to validate the framework, optimise methods for assessment, develop approaches to integrate it within the sector and measure its impact on performance.

  10. The Reputational Consequences of Generalized Trust

    PubMed Central

    Evans, Anthony M.; van de Calseyde, Philippe P. F. M.

    2017-01-01

    The present research examines the reputational consequences of generalized trust. High-trust individuals are seen as moral and sociable, but not necessarily competent. When controlling for other traits, there is a negative relationship between trust and perceived competence (Studies 1 and 2). Compared with optimism, generalized trust has stronger effects on morality and sociability (Study 2). Furthermore, people judge those who do not discriminate between trustworthy and untrustworthy groups (unconditional trustors) more negatively than those who only trust groups that are, in fact, trustworthy (conditional trustors). Unconditional trust and unconditional distrust are both viewed negatively (Study 3), even after controlling for attitudinal similarity (Study 4). Critically, both generalized trust and discriminant ability (i.e., conditional trust) have independent reputational benefits (Study 5). These studies suggest that generalized trust plays an important role in how we perceive and judge others. PMID:29251247

  11. Error behaviors associated with loss of competency in Alzheimer's disease.

    PubMed

    Marson, D C; Annis, S M; McInturff, B; Bartolucci, A; Harrell, L E

    1999-12-10

    To investigate qualitative behavioral changes associated with declining medical decision-making capacity (competency) in patients with AD. Qualitative measures can yield clinical information about functional changes in neurologic disease not available through quantitative measures. Normal older controls (n = 21) and patients with mild and moderate probable AD (n = 72) were compared using a standardized competency measure and neuropsychological measures. A system of 16 qualitative error scores representing conceptual domains of language, executive dysfunction, affective dysfunction, and compensatory responses was used to analyze errors produced on the competency measure. Patterns of errors were examined across groups. Relationships between error behaviors and competency performance were determined, and neurocognitive correlates of specific error behaviors were identified. AD patients demonstrated more miscomprehension, factual confusion, intrusions, incoherent responses, nonresponsive answers, loss of task, and delegation than controls. Errors in the executive domain (loss of task, nonresponsive answer, and loss of detachment) were key predictors of declining competency performance by AD patients. Neuropsychological analyses in the AD group generally confirmed the conceptual domain assignments of the qualitative scores. Loss of task, nonresponsive answers, and loss of detachment were key behavioral changes associated with declining competency of AD patients and with neurocognitive measures of executive dysfunction. These findings support the growing linkage between executive dysfunction and competency loss.

  12. A case study of organisational Cultural Competence in mental healthcare.

    PubMed

    Adamson, Jean; Warfa, Nasir; Bhui, Kamaldeep

    2011-09-15

    Ensuring Cultural Competence (CC) in health care is a mechanism to deliver culturally appropriate care and optimise recovery. In policies that promote cultural competence, the training of mental health practitioners is a key component of a culturally competent organisation. This study examines staff perceptions of CC and the integration of CC principles in a mental healthcare organisation. The purpose is to show interactions between organisational and individual processes that help or hinder recovery orientated services. We carried out a case study of a large mental health provider using a cultural competence needs analysis. We used structured and semi-structured questionnaires to explore the perceptions of healthcare professionals located in one of the most ethnically and culturally diverse areas of England, its capital city London. There was some evidence that clinical staff were engaged in culturally competent activities. We found a growing awareness of cultural competence amongst staff in general, and many had attended training. However, strategic plans and procedures that promote cultural competence tended to not be well communicated to all frontline staff; whilst there was little understanding at corporate level of culturally competent clinical practices. The provider organisation had commenced a targeted recruitment campaign to recruit staff from under-represented ethnic groups and it developed collaborative working patterns with service users. There is evidence to show tentative steps towards building cultural competence in the organisation. However, further work is needed to embed cultural competence principles and practices at all levels of the organisation, for example, by introducing monitoring systems that enable organisations to benchmark their performance as a culturally capable organisation.

  13. Resident self-other assessor agreement: influence of assessor, competency, and performance level.

    PubMed

    Lipsett, Pamela A; Harris, Ilene; Downing, Steven

    2011-08-01

    To review the literature on self-assessment in the context of resident performance and to determine the correlation between self-assessment across competencies in high- and low-performing residents and assessments performed by raters from a variety of professional roles (peers, nurses, and faculty). Retrospective analysis of prospectively collected anonymous self-assessment and multiprofessional (360) performance assessments by competency and overall. University-based academic general surgical program. Sixty-two residents rotating in general surgery. Mean difference for each self-assessment dyad (self-peer, self-nurse, and self-attending physician) by resident performance quartile, adjusted for measurement error, correlation coefficients, and summed differences across all competencies. Irrespective of self-other dyad, residents asked to rate their global performance overestimated their skills. Residents in the upper quartile underestimated their specific skills while those in the lowest-performing quartile overestimated their abilities when compared with faculty, peers, and especially nurse raters. Moreover, overestimation was greatest in competencies related to interpersonal skills, communication, teamwork, and professionalism. Rater, level of performance, and the competency being assessed all influence the comparison of the resident's self-assessment and those of other raters. Self-assessment of competencies related to behavior may be inaccurate when compared with raters from various professions. Residents in the lowest-performing quartile are least able to identify their weakness. These data have important implications for residents, program directors, and the public and suggest that strategies that help the lowest-performing residents recognize areas in need of improvement are needed.

  14. Unethical and inept? The influence of moral information on perceptions of competence.

    PubMed

    Stellar, Jennifer E; Willer, Robb

    2018-02-01

    While moral character heavily influences global evaluations of others (Goodwin, Piazza, & Rozin, 2014), its causal effect on perceptions of others' competence (i.e., one's knowledge, skills, and abilities) is less clear. We found that people readily use information about another's morality when judging their competence, despite holding folk intuitions that these domains are independent. Across 6 studies (n = 1,567), including 2 preregistered experiments, participants judged targets who committed hypothetical transgressions (Studies 1 and 3), cheated on lab tasks (Study 2), acted selfishly in economic games (Study 4), and received low morality ratings from coworkers (Study 5 and 6) as less competent than control or moral targets. These findings were specific to morality and were not the result of incidentally manipulating impressions of warmth (Study 4), nor were they fully explained by a general halo effect (Studies 2 and 3). We hypothesized that immoral targets are seen as less competent because their immoral actions led them to be viewed as low in social intelligence. Studies 4 and 5 supported this prediction, demonstrating that social intelligence was a more reliable mediator than perceptions of self-control or general intelligence. An experimental test of this mediation argument found that presenting targets as highly socially intelligent eliminated the negative effect of immoral information on judgments of competence (Study 6). These results suggest that information about a person's moral character readily influences perceptions of their competence. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  15. Theme: Coping with Competencies.

    ERIC Educational Resources Information Center

    Brown, Daniel; And Others

    1989-01-01

    Consists of five articles on the topic of competencies in vocational agriculture. Topics covered include (1) competency-based instruction, (2) competencies for agricultural recordkeeping, (3) competencies in hydroponics, and (4) competencies in agribusiness. (CH)

  16. Here, There, and (Almost) Everywhere: Civil Religion and Cultural Competency

    ERIC Educational Resources Information Center

    Nyitray, Vivian-Lee

    2018-01-01

    When preparing students for study abroad, understanding the religious dimension of the target country/culture is generally viewed as essential for cultural competency training. What is generally left unexamined is the civil religious culture that might be operative. This essay first provides an introduction to the concept as it was introduced by…

  17. How do early career health sciences information professionals gain competencies?

    PubMed

    Myers, Bethany A; Rodriguez, Bredny

    2016-07-01

    The purpose of this study was to describe early career health sciences information professionals' self-reported attainment of the Medical Library Association (MLA) Competencies for Lifelong Learning and Professional Success and to investigate the various methods by which participants developed these competencies. A SurveyMonkey survey was designed to ascertain participants' demographic information and their competency attainment. "Early career" health information professionals were defined as those with less than five years of professional experience. Participants were asked to rate each of the seven competencies on a five-point Likert scale regarding their level of agreement with the statement, "I have demonstrated this competency." Participants who responded positively were then asked to indicate how they acquired the competency on a multiple-choice, multiple-answer list. Free-text fields were provided for general comments and for participants to elaborate on their answers. The survey was distributed through the MLA email discussion list and other related email discussion lists. Participation was anonymous. One hundred eighty-seven responses were received. Out of those 187 respondents, 95 completed the entire survey. The majority of early career health sciences information professionals agreed that they had attained all 7 competencies. Of the various methods used to develop competencies, the most selected method was formal library and information studies education. Participants were least likely to report attaining competencies via mentoring, volunteering, or internships. Participants reported the highest level of confidence in having attained the "Health Sciences Information Services" competency, and the lowest level of confidence in having attained the "Research, Analysis, and Interpretation" competency. These results contribute to the ongoing discussions regarding proposed changes to the MLA competencies. The results may also inform the development of

  18. Core competencies in clinical neuropsychology training across the world.

    PubMed

    Hessen, Erik; Hokkanen, Laura; Ponsford, Jennie; van Zandvoort, Martine; Watts, Ann; Evans, Jonathan; Haaland, Kathleen Y

    2018-05-01

    This work aimed to review main competency requirements from training models in countries with well-established specialties in clinical neuropsychology and to extract core competencies that likely will apply to clinical neuropsychologists regardless of regional and cultural context. We reviewed standards for post-graduate training in clinical neuropsychology from countries in Europe, Australia, and North America based on existing literature, presentations at international conferences, and from description of the training models from national psychological or neuropsychological associations. Despite differences, the reviewed models share similar core competencies considered necessary for a specialty in clinical neuropsychology: (1) In-depth knowledge of general psychology including clinical psychology (post-graduate level), ethical, and legal standards. (2) Expert knowledge about clinically relevant brain-behavioral relationships. (3) Comprehensive knowledge about, and skills in, related clinical disciplines. (4) In-depth knowledge about and skills in neuropsychological assessment, including decision-making and diagnostic competency according to current classification of diseases. (5) Competencies in the area of diversity and culture in relation to clinical neuropsychology. (6) Communication competency of neuropsychological findings and test results to relevant and diverse audiences. (7) Knowledge about and skills in psychological and neuropsychological intervention, including treatment and rehabilitation. All the models have undergone years of development in accordance with requirements of national health care systems in different parts of the world. Despite differences, the common core competency requirements across different regions of the world suggest generalizability of these competencies. We hope this summary can be useful as countries with less established neuropsychology training programs develop their models.

  19. Competence, competency-based education, and undergraduate dental education: a discussion paper.

    PubMed

    Chuenjitwongsa, S; Oliver, R G; Bullock, A D

    2018-02-01

    The aim of undergraduate dental education is to provide competent dentists to serve societal needs and improve population oral healthcare. Competency-based education has influenced the development of dental education for decades but this term is problematic. This article explores components of competency-based undergraduate health professional education in order to help the dental profession have a better understanding of the context and purposes of undergraduate dental education. This is a discussion paper based on a wide reading of the literature on the education of health professionals with a specific focus on competency-based undergraduate education. Competence comprises an integration of knowledge, skills and attitudes indicating a capability to perform professional tasks safely and ethically. The process of becoming a competent practitioner is complex. Four characteristics of competency-based education are: curriculum components and content shaped by societal needs; focused on student-centred learning; learning achievement; and limited attention to time-based training and numerical targets. Alongside a competency-based approach, undergraduate dental education can be influenced by institutional features and external factors but these receive little consideration in the literature. Understanding competence, competency-based education, and institutional and external factors will help to improve educational quality, define roles and professional development for the dental educator, and inform further research. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. (Re)Introducing communication competence to the health professions.

    PubMed

    Spitzberg, Brian H

    2013-12-01

    Despite the central role that communication skills play in contemporary accounts of effective health care delivery in general, and the communication of medical error specifically, there is no common or consensual core in the health professions regarding the nature of such skills. This lack of consensus reflects, in part, the tendency for disciplines to reinvent concepts and measures without first situating such development in disciplines with more cognate specialization in such concepts. In this essay, an integrative model of communication competence is introduced, along with its theoretical background and rationale. Communication competence is defined as an impression of appropriateness and effectiveness, which is functionally related to individual motivation, knowledge, skills, and contextual facilitators and constraints. Within this conceptualization, error disclosure contexts are utilized to illustrate the heuristic value of the theory, and implications for assessment are suggested. Significance for public healthModels matter, as do the presuppositions that underlie their architecture. Research indicates that judgments of competence moderate outcomes such as satisfaction, trust, understanding, and power-sharing in relationships and in individual encounters. If the outcomes of health care encounters depend on the impression of competence that patients or their family members have of health care professionals, then knowing which specific communicative behaviors contribute to such impressions is not merely important - it is essential. To pursue such a research agenda requires that competence assessment and operationalization becomes better aligned with conceptual assumptions that separate behavioral performance from the judgments of the competence of that performance.

  1. Do final-year medical students have sufficient prescribing competencies? A systematic literature review.

    PubMed

    Brinkman, David J; Tichelaar, Jelle; Graaf, Sanne; Otten, René H J; Richir, Milan C; van Agtmael, Michiel A

    2018-04-01

    Prescribing errors are an important cause of patient safety incidents and are frequently caused by junior doctors. This might be because the prescribing competence of final-year medical students is poor as a result of inadequate clinical pharmacology and therapeutic (CPT) education. We reviewed the literature to investigate which prescribing competencies medical students should have acquired in order to prescribe safely and effectively, and whether these have been attained by the time they graduate. PubMed, EMBASE and ERIC databases were searched from the earliest dates up to and including January 2017, using the terms 'prescribing', 'competence' and 'medical students' in combination. Articles describing or evaluating essential prescribing competencies of final-year medical students were included. Twenty-five articles describing, and 47 articles evaluating, the prescribing competencies of final-year students were included. Although there seems to be some agreement, we found no clear consensus among CPT teachers on which prescribing competencies medical students should have when they graduate. Studies showed that students had a general lack of preparedness, self-confidence, knowledge and skills, specifically regarding general and antimicrobial prescribing and pharmacovigilance. However, the results should be interpreted with caution, given the heterogeneity and methodological weaknesses of the included studies. There is considerable evidence that final-year students have insufficient competencies to prescribe safely and effectively, although there is a need for a greater consensus among CPT teachers on the required competencies. Changes in undergraduate CPT education are urgently required in order to improve the prescribing of future doctors. © 2018 VU University Medical Centre. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

  2. What Does Competence Entail in Interventional Radiology?

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ahmed, Kamran, E-mail: k.ahmed@imperial.ac.u; Keeling, Aoife N.; Khan, Reenam S.

    2010-02-15

    Interventional radiology is a relatively new speciality and may be referred to as 'image-guided surgery without a scalpel.' Training and accreditation bodies regard interventional radiology training as being 'different' from general radiology because of the additional need for dexterity and clinical acumen. Due to the multidimensional role of an interventional radiologist, a practitioner in this discipline must have a number of the competencies of anesthetists, surgeons, and radiologists. The attributes required of an interventional radiologist are akin to those required of a surgeon. This paper gives an overview of the skills required to be a competent interventional radiologist along withmore » a succinct introduction to methods of assessment of technical and non-technical skills.« less

  3. 42 CFR 50.203 - Sterilization of a mentally competent individual aged 21 or older.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Sterilization of a mentally competent individual... HUMAN SERVICES GRANTS POLICIES OF GENERAL APPLICABILITY Sterilization of Persons in Federally Assisted Family Planning Projects § 50.203 Sterilization of a mentally competent individual aged 21 or older...

  4. Semi-Competing Risks Data Analysis: Accounting for Death as a Competing Risk When the Outcome of Interest is Non-Terminal

    PubMed Central

    Haneuse, Sebastien; Lee, Kyu Ha

    2016-01-01

    Hospital readmission is a key marker of quality of health care. Notwithstanding its widespread use, however, it remains controversial in part because statistical methods used to analyze readmission, primarily logistic regression and related models, may not appropriately account for patients who die prior to experiencing a readmission event within the timeframe of interest. Towards resolving this, we describe and illustrate the semi-competing risks framework, which refers to the general setting where scientific interest lies with some non-terminal event (e.g. readmission), the occurrence of which is subject to a terminal event (e.g. death). Although a number of statistical analysis methods have been proposed for semi-competing risks data, we describe in detail the use of illness-death models primarily because of their relation to well-known methods for survival analysis and the availability of software. We also describe and consider in detail a number of existing approaches that could, in principle, be used to analyze semi-competing risks data including composite endpoint and competing risks analyses. Throughout we illustrate the ideas and methods using data on N=49,763 Medicare beneficiaries hospitalized between 2011–2013 with a principle discharge diagnosis of heart failure. PMID:27072677

  5. The Swiss Health Literacy Survey: development and psychometric properties of a multidimensional instrument to assess competencies for health

    PubMed Central

    Wang, Jen; Thombs, Brett D.; Schmid, Margareta R.

    2012-01-01

    Abstract Background  Growing recognition of the role of citizens and patients in health and health care has placed a spotlight on health literacy and patient education. Objective  To identify specific competencies for health in definitions of health literacy and patient‐centred concepts and empirically test their dimensionality in the general population. Methods  A thorough review of the literature on health literacy, self‐management, patient empowerment, patient education and shared decision making revealed considerable conceptual overlap as competencies for health and identified a corpus of 30 generic competencies for health. A questionnaire containing 127 items covering the 30 competencies was fielded as a telephone interview in German, French and Italian among 1255 respondents randomly selected from the resident population in Switzerland. Findings  Analyses with the software MPlus to model items with mixed response categories showed that the items do not load onto a single factor. Multifactorial models with good fit could be erected for each of five dimensions defined a priori and their corresponding competencies: information and knowledge (four competencies, 17 items), general cognitive skills (four competencies, 17 items), social roles (two competencies, seven items), medical management (four competencies, 27 items) and healthy lifestyle (two competencies, six items). Multiple indicators and multiple causes models identified problematic differential item functioning for only six items belonging to two competencies. Conclusions  The psychometric analyses of this instrument support broader conceptualization of health literacy not as a single competence but rather as a package of competencies for health. PMID:22390287

  6. Surgeons' attitude toward a competency-based training and assessment program: results of a multicenter survey.

    PubMed

    Hopmans, Cornelis J; den Hoed, Pieter T; Wallenburg, Iris; van der Laan, Lijkckle; van der Harst, Erwin; van der Elst, Maarten; Mannaerts, Guido H H; Dawson, Imro; van Lanschot, Jan J B; Ijzermans, Jan N M

    2013-01-01

    Currently, most surgical training programs are focused on the development and evaluation of professional competencies. Also in the Netherlands, competency-based training and assessment programs were introduced to restructure postgraduate medical training. The current surgical residency program is based on the Canadian Medical Education Directives for Specialists (CanMEDS) competencies and uses assessment tools to evaluate residents' competence progression. In this study, we examined the attitude of surgical residents and attending surgeons toward a competency-based training and assessment program used to restructure general surgical training in the Netherlands in 2009. In 2011, all residents (n = 51) and attending surgeons (n = 108) in 1 training region, consisting of 7 hospitals, were surveyed. Participants were asked to rate the importance of the CanMEDS competencies and the suitability of the adopted assessment tools. Items were rated on a 5-point Likert scale and considered relevant when at least 80% of the respondents rated an item with a score of 4 or 5 (indicating a positive attitude). Reliability was evaluated by calculating the Cronbach's α, and the Mann-Whitney test was applied to assess differences between groups. The response rate was 88% (n = 140). The CanMEDS framework demonstrated good reliability (Cronbach's α = 0.87). However, the importance of the competencies 'Manager' (78%) and 'Health Advocate' (70%) was undervalued. The assessment tools failed to achieve an acceptable reliability (Cronbach's α = 0.55), and individual tools were predominantly considered unsuitable for assessment. Exceptions were the tools 'in-training evaluation report' (91%) and 'objective structured assessment of technical skill' (82%). No significant differences were found between the residents and the attending surgeons. This study has demonstrated that, 2 years after the reform of the general surgical residency program, residents and attending surgeons in a large

  7. Associations among attitudes, perceived difficulty of learning science, gender, parents' occupation and students' scientific competencies

    NASA Astrophysics Data System (ADS)

    Chi, ShaoHui; Wang, Zuhao; Liu, Xiufeng; Zhu, Lei

    2017-11-01

    This study investigated the associations among students' attitudes towards science, students' perceived difficulty of learning science, gender, parents' occupations and their scientific competencies. A sample of 1591 (720 males and 871 females) ninth-grade students from 29 junior high schools in Shanghai completed a scientific competency test and a Likert scale questionnaire. Multiple regression analysis revealed that students' general interest of science, their parents' occupations and perceived difficulty of science significantly associated with their scientific competencies. However, there was no gender gap in terms of scientific competencies.

  8. The Interrelations between Competences for Sustainable Development and Research Competences

    ERIC Educational Resources Information Center

    Lambrechts, Wim; Van Petegem, Peter

    2016-01-01

    Purpose: The purpose of this paper is to explore how competences for sustainable development and research interrelate within a context of competence-based higher education. Specific focus is oriented towards strengthening research competences for sustainability. Design/methodology/approach: Following a hermeneutic-interpretive methodology, this…

  9. Do final‐year medical students have sufficient prescribing competencies? A systematic literature review

    PubMed Central

    Tichelaar, Jelle; Graaf, Sanne; Otten, René H. J.; Richir, Milan C.; van Agtmael, Michiel A.

    2018-01-01

    Aims Prescribing errors are an important cause of patient safety incidents and are frequently caused by junior doctors. This might be because the prescribing competence of final‐year medical students is poor as a result of inadequate clinical pharmacology and therapeutic (CPT) education. We reviewed the literature to investigate which prescribing competencies medical students should have acquired in order to prescribe safely and effectively, and whether these have been attained by the time they graduate. Methods PubMed, EMBASE and ERIC databases were searched from the earliest dates up to and including January 2017, using the terms ‘prescribing’, ‘competence’ and ‘medical students’ in combination. Articles describing or evaluating essential prescribing competencies of final‐year medical students were included. Results Twenty‐five articles describing, and 47 articles evaluating, the prescribing competencies of final‐year students were included. Although there seems to be some agreement, we found no clear consensus among CPT teachers on which prescribing competencies medical students should have when they graduate. Studies showed that students had a general lack of preparedness, self‐confidence, knowledge and skills, specifically regarding general and antimicrobial prescribing and pharmacovigilance. However, the results should be interpreted with caution, given the heterogeneity and methodological weaknesses of the included studies. Conclusions There is considerable evidence that final‐year students have insufficient competencies to prescribe safely and effectively, although there is a need for a greater consensus among CPT teachers on the required competencies. Changes in undergraduate CPT education are urgently required in order to improve the prescribing of future doctors. PMID:29315721

  10. A case study of organisational cultural competence in mental healthcare

    PubMed Central

    2011-01-01

    Background Ensuring Cultural Competence (CC) in health care is a mechanism to deliver culturally appropriate care and optimise recovery. In policies that promote cultural competence, the training of mental health practitioners is a key component of a culturally competent organisation. This study examines staff perceptions of CC and the integration of CC principles in a mental healthcare organisation. The purpose is to show interactions between organisational and individual processes that help or hinder recovery orientated services. Methods We carried out a case study of a large mental health provider using a cultural competence needs analysis. We used structured and semi-structured questionnaires to explore the perceptions of healthcare professionals located in one of the most ethnically and culturally diverse areas of England, its capital city London. Results There was some evidence that clinical staff were engaged in culturally competent activities. We found a growing awareness of cultural competence amongst staff in general, and many had attended training. However, strategic plans and procedures that promote cultural competence tended to not be well communicated to all frontline staff; whilst there was little understanding at corporate level of culturally competent clinical practices. The provider organisation had commenced a targeted recruitment campaign to recruit staff from under-represented ethnic groups and it developed collaborative working patterns with service users. Conclusion There is evidence to show tentative steps towards building cultural competence in the organisation. However, further work is needed to embed cultural competence principles and practices at all levels of the organisation, for example, by introducing monitoring systems that enable organisations to benchmark their performance as a culturally capable organisation. PMID:21920044

  11. The problem resident behavior guide: strategies for remediation.

    PubMed

    Williamson, Kelly; Quattromani, Erin; Aldeen, Amer

    2016-04-01

    In 2012, the ACGME supplemented the core competencies with outcomes-based milestones for resident performance within the six competency domains. These milestones address the knowledge, skills, abilities, attitudes, and experiences that a resident is expected to progress through during the course of training. Even prior to the initiation of the milestones, there was a paucity of EM literature addressing the remediation of problem resident behaviors and there remain few readily accessible tools to aid in the implementation of a remediation plan. The goal of the "Problem Resident Behavior Guide" is to provide specific strategies for resident remediation based on deficiencies identified within the framework of the EM milestones. The "Problem Resident Behavior Guide" is a written instructional manual that provides concrete examples of remediation strategies to address specific milestone deficiencies. The more than 200 strategies stem from the experiences of the authors who have professional experience at three different academic hospitals and emergency medicine residency programs, supplemented by recommendations from educational leaders as well as utilization of valuable education adjuncts, such as focused simulation exercises, lecture preparation, and themed ED shifts. Most recommendations require active participation by the resident with guidance by faculty to achieve the remediation expectations. The ACGME outcomes-based milestones aid in the identification of deficiencies with regards to resident performance without providing recommendations on remediation. The Problem Resident Behavior Guide can therefore have a significant impact by filling in this gap.

  12. Risk Competence in Dealing With Alcohol and Other Drugs in Adolescence.

    PubMed

    Nagy, Ede; Verres, Rolf; Grevenstein, Dennis

    2017-12-06

    Adolescence is a critical phase for the development substance use patterns. We propose that individual competence in dealing with psychoactive substances is crucial for the development of healthy substance use behavior and prevention of substance misuse or addiction. We present a new concept of health related skills in dealing with alcohol and other drugs in adolescence, its operationalization and validation. Our conception of risk competence (RICO) consists of the four major factors being Reflective, Informed, Self-Controlled and Life-Oriented, and their sub-facets. Based on a sample of N = 753 adolescents we used classical test theory as well as item response theory to create a new measure of RICO. Validity was investigated in a new sample of N = 229 with regard to substance use, risk perception, and measures of personality (Big Five, sense of coherence, general self-efficacy). RICO contains 7 scales with 28 items that measure independent aspects of risk competence. Cross-sectional criterion validity for most of the scales could be shown. Conclusions/Importance: The new RICO scales are a valid measure of different aspects of risk competence in dealing with psychoactive substances. The questionnaire can be used in general research settings, but may also be applied to assess the effects of interventions.

  13. Being Close and Being Social: Peer Ratings of Distinct Aspects of Young Adult Social Competence

    PubMed Central

    Larson, Justine J.; Whitton, Sarah W.; Hauser, Stuart T.; Allen, Joseph P.

    2012-01-01

    The present study had three main objectives: (1) to develop and validate scales of young adult social competence in two domains, close relationships and social groups, using peer ratings of California Q-sort (Block, 1974; Kremen & Block, 2002) items; (2) to test the hypothesis that social competence is associated with young adult well-being and ego development; (3) to test the hypothesis that close relationship competence aligns more closely than social group competence with young adult functioning. Psychometric data on peer ratings of social competence are presented. For 133 young adults, peer ratings of social competence were correlated in expected directions with indices of functioning (e.g., self-worth, education, psychological distress, criminal behavior, and ego development). Associations were generally stronger for competence in close relationships than in social groups. PMID:17764391

  14. Rethinking cultural competence: insights from indigenous community treatment settings.

    PubMed

    Wendt, Dennis C; Gone, Joseph P

    2012-04-01

    Multicultural professional psychologists routinely assert that psychotherapeutic interventions require culturally competent delivery for ethnoracial minority clients to protect the distinctive cultural orientations of these clients. Dominant disciplinary conceptualizations of cultural competence are "kind of person" models that emphasize specialized awareness, knowledge, and skills on the part of the practitioner. Even within psychology, this approach to cultural competence is controversial owing to professional misgivings concerning its culturally essentialist assumptions. Unfortunately, alternative "process-oriented" models of cultural competence emphasize such generic aspects of therapeutic interaction that they remain in danger of losing sight of culture altogether. Thus, for cultural competence to persist as a meaningful construct, an alternative approach that avoids both essentialism and generalism must be recovered. One means to capture this alternative is to shift focus away from culturally competent therapists toward culturally commensurate therapies. Indigenous communities in North America represent interesting sites for exploring this shift, owing to widespread political commitments to Aboriginal cultural reclamation in the context of postcoloniality. Two examples from indigenous communities illustrate a continuum of cultural commensurability that ranges from global psychotherapeutic approaches at one end to local healing traditions at the other. Location of culturally integrative efforts by indigenous communities along this continuum illustrates the possibility for local, agentic, and intentional deconstructions and reconstructions of mental health interventions in a culturally hybrid fashion.

  15. Culture and Cultural Competence in Nursing Education and Practice: The State of the Art.

    PubMed

    Harkess, Linda; Kaddoura, Mahmoud

    2016-07-01

    The concept of cultural competency has developed a substantial presence in nursing education and practice since first attracting widespread attention in the 1990s. While several theories and corresponding measures of cultural competency have been advanced and tried, much work remains, as many nursing professionals continue to call for greater evidence-based research and attention to patient perspectives and outcomes. Using a method provided by Hawker et al. to appraise articles, this paper compares nine recent (2008-2013) studies (including two composite studies) related to cultural competency, undergraduate curricula, and teaching strategies in nursing to assess the state of the art in this important area of care. The studies applied phenomenological, study abroad, online, and service learning strategies, four of which relied on some version of Campinha-Bacote's IAPCC© model. These studies reported a general improvement in competency among students, though generally only to a level of cultural awareness, and admitted being constrained by several common limitations. Improved results and more realistic expectations in this area may require a closer understanding of the nature of the "culture" that underlies cultural competence. Harkess Kaddoura. © 2015 Wiley Periodicals, Inc.

  16. A qualitative assessment of internal medicine resident perceptions of graduate medical education following implementation of the 2011 ACGME duty hour standards

    PubMed Central

    2014-01-01

    Background In 2011, the Accreditation Council of Graduate Medical Education implemented updated guidelines for medical resident duty hours, further limiting continuous work hours for first-year residents. We sought to investigate the impact of these restrictions on graduate medical education among internal medicine residents. Methods We conducted eight focus groups with internal medicine residents at the University of Alabama at Birmingham in 06/2012-07/2012. Discussion questions included, “How do you feel the 2011 ACGME work hour restrictions have impacted your graduate medical education?” Transcripts of the focus groups were reviewed and themes identified using a deductive/inductive approach. Participants completed a survey to collect demographic information and future practice plans. Results Thirty-four residents participated in our focus groups. Five themes emerged: decreased teaching, decreased experiential learning, shift-work mentality, tension between residency classes, and benefits and opportunities. Residents reported that since implementation of the guidelines, teaching was often deferred to complete patient-care tasks. Residents voiced concern that PGY-1 s were not receiving adequate clinical experience and that procedural and clinical reasoning skills are being negatively impacted. PGY-1 s reported being well-rested and having increased time for independent study. Conclusions Residents noted a decline in teaching and are concerned with the decrease in “hands-on” clinical education that is inevitably impacted by fewer hours in the hospital, though some benefits were also reported. Future studies are needed to further elucidate the impact of decreased resident work hours on graduate medical education. PMID:24755276

  17. Emotional and Prosocial Correlates of Teachers' Ratings of Preschool Social Competence and Behavior Problems.

    ERIC Educational Resources Information Center

    Denham, Susanne A.

    Teachers' ratings are often used as early as the preschool period to provide an overall picture of children's behavioral adjustment and social competence. The goals of this study are to (1) show the relations among general, outcome-oriented observational categories of preschoolers' social competence and (2) specify those discrete emotions and…

  18. Racial/Ethnic Disparities in Therapist Effectiveness: A Conceptualization and Initial Study of Cultural Competence

    ERIC Educational Resources Information Center

    Imel, Zac E.; Baldwin, Scott; Atkins, David C.; Owen, Jesse; Baardseth, Tim; Wampold, Bruce E.

    2011-01-01

    As a result of mental health disparities between White and racial/ethnic minority clients, researchers have argued that some therapists may be generally competent to provide effective services but lack cultural competence. This distinction assumes that client racial/ethnic background is a source of variability in therapist effectiveness. However,…

  19. Training Emotional and Social Competences in Higher Education: The Seminar Methodology

    ERIC Educational Resources Information Center

    Oberst, Ursula; Gallifa, Josep; Farriols, Nuria; Vilaregut, Anna

    2009-01-01

    This article discusses the importance of emotional and social competences in higher education and presents a training model. In 1991, Ramon Llull University of Barcelona (Spain) created the Seminar methodology to tackle these challenges. A general model derived from the Emotional Intelligence concept and the general principles of this methodology…

  20. Differential effects of self-esteem and interpersonal competence on humor styles

    PubMed Central

    McCosker, Bernadette; Moran, Carmen C

    2012-01-01

    Background In contrast with an early implicit “facilitative hypothesis” of humor, a revised specificity hypothesis predicts that the benefits of humor depend on the specific style of humor used. Information on predictors of these humor styles in turn enhances the ability to predict the effect on well-being. Methods We examined the relationships between interpersonal competence, self-esteem, and different styles of humor, while also examining the contributions of age and gender. Participants (n = 201) aged 18–63 years completed the Rosenberg Self-Esteem Inventory, the Interpersonal Competence Questionnaire, and the Humor Styles Questionnaire, and gave demographic information. Results High self-esteem was associated with higher use of affiliative, aggressive, and self-enhancing humor styles, but lower use of self-defeating humor. High interpersonal competence predicted greater use of affiliative humor, whereas low interpersonal competence predicted greater use of aggressive humor. Further analyses showed that initiation competence predicted affiliative humor (positively) but both initiation competence (positively) and conflict management competence (negatively) predicted aggressive humor. Conclusion The findings that both self-esteem and initiation competence contribute to use of aggressive humor add to knowledge of who is likely to use this potentially harmful humor style. We conclude that a readiness to initiate humorous interactions is not on its own a general and positive attribute contributing to “good” humor. PMID:23180973

  1. Athletic Coaching Competencies.

    ERIC Educational Resources Information Center

    Nathanson, Stephen J.

    1979-01-01

    This article describes a study conducted to identify the competencies appropriate for an athletic coach and to incorporate those competencies into a competency based coaching education program for the four-year colleges and universities within the New York state systems. (JMF)

  2. (Re)Introducing Communication Competence to the Health Professions

    PubMed Central

    Spitzberg, Brian H.

    2013-01-01

    Despite the central role that communication skills play in contemporary accounts of effective health care delivery in general, and the communication of medical error specifically, there is no common or consensual core in the health professions regarding the nature of such skills. This lack of consensus reflects, in part, the tendency for disciplines to reinvent concepts and measures without first situating such development in disciplines with more cognate specialization in such concepts. In this essay, an integrative model of communication competence is introduced, along with its theoretical background and rationale. Communication competence is defined as an impression of appropriateness and effectiveness, which is functionally related to individual motivation, knowledge, skills, and contextual facilitators and constraints. Within this conceptualization, error disclosure contexts are utilized to illustrate the heuristic value of the theory, and implications for assessment are suggested. Significance for public health Models matter, as do the presuppositions that underlie their architecture. Research indicates that judgments of competence moderate outcomes such as satisfaction, trust, understanding, and power-sharing in relationships and in individual encounters. If the outcomes of health care encounters depend on the impression of competence that patients or their family members have of health care professionals, then knowing which specific communicative behaviors contribute to such impressions is not merely important – it is essential. To pursue such a research agenda requires that competence assessment and operationalization becomes better aligned with conceptual assumptions that separate behavioral performance from the judgments of the competence of that performance. PMID:25170494

  3. minSKIN does a multifaceted intervention improve the competence in the diagnosis of skin cancer by general practitioners? Study protocol for a randomised controlled trial.

    PubMed

    Badertscher, Nina; Rosemann, Thomas; Tandjung, Ryan; Braun, Ralph P

    2011-06-30

    In Switzerland, skin cancer is one of the most common neoplasms. Melanoma is the most aggressive one and can be lethal if not detected and removed on time. Nonmelanoma skin cancer is more frequent as melanoma; it is seldom lethal but can disfigure patients in advanced stages. General practitioners (GPs) are often faced with suspicious skin lesions of their patients. Randomised controlled trial (RCT). 60 GPs, randomised into intervention group and control group. GPs get a Lumio loupe, a digital camera and continuous feedback based on pictures of skin lesions they send to the Dermatologist. Competence in the diagnosis of skin cancer by GPs, measured as the percentage of correctly classified pictures of skin lesions. At baseline, and prior to any intervention (T0), GPs will be asked to rate 36 pictures of skin lesions according to their likelihood of malignancy on a visual analogue scale (VAS). After a full day training course with both groups (T1) and after one year of continuous feedback (T2) with the intervention group, we will repeat the picture scoring session with both groups, using new pictures. We want to determine whether a multifaceted intervention (including technical equipment and a continuous feedback on skin lesions) leads to an improved competence in the diagnosis of skin cancer by GPs. This study addresses the hypothesis that an additional feedback loop, based on pictures performed in daily practice by GPs is superior to a simple educational intervention regarding diagnostic competence. We expect an improvement of the competence in skin cancer diagnosis by GPs in both groups after the full day training course. Beside this immediate effect, we also expect a long term effect in the intervention group because of the continuous problem based feedback. ISRCTN29854485.

  4. Coaches’ Perceptions of Competence and Acknowledgement of Training Needs Related to Professional Competences

    PubMed Central

    Santos, Sofia; Mesquita, Isabel; GRAÇA, Amândio; Rosado, António

    2010-01-01

    The purpose of the present study was to examine coaches’ perceptions of competence and acknowledgement of training needs related to professional competences according to the professional experience and academic education. The participants were 343 coaches from several sports, who answered to a questionnaire that includes a scale focused on perceptions of competence and another scale on acknowledgment of training needs. An exploratory factor analysis with Maximum Likelihood Factoring was used with Oblimin rotation for the identification of emergent factors. Comparison on coaches’ perceptions in function of coaching experience and coaches’ academic background were made applying One-way ANOVA and Tukey’s post hoc multiple comparisons. Factor analysis on coaches’ perceptions of competence and acknowledgement of training needs made apparent three main areas of competences, i.e. competences related to annual and multi-annual planning; competences related to orientation towards practice and competition; and personal and coaching education competences. Coaches’ perceptions were influenced by their experience, as low experienced coaches rated themselves at lower levels of competence and with more training needs; also coaches with high education, in Physical Education or others, perceived themselves as more competent than coaches with no higher education. Finally, the majority of the coaches perceived themselves to be competent but, nevertheless, they indicated to have training needs, which brings an important feedback to coach education. This suggests that coaches are interested in increasing their knowledge and competence in a broad range of areas which should be considered in future coach education programs. Key points Coaches’ perceptions of competence and acknowledgement of training needs resulted in three main areas: competences related to annual and multi-annual planning, competences related to practice and competition orientation and, finally, personal

  5. Motor Skill Competence and Perceived Motor Competence: Which Best Predicts Physical Activity among Girls?

    PubMed

    Khodaverdi, Zeinab; Bahram, Abbas; Khalaji, Hassan; Kazemnejad, Anoshirvan

    2013-10-01

    The main purpose of this study was to determine which correlate, perceived motor competence or motor skill competence, best predicts girls' physical activity behavior. A sample of 352 girls (mean age=8.7, SD=0.3 yr) participated in this study. To assess motor skill competence and perceived motor competence, each child completed the Test of Gross Motor Development-2 and Physical Ability sub-scale of Marsh's Self-Description Questionnaire. Children's physical activity was assessed by the Physical Activity Questionnaire for Older Children. Multiple linear regression model was used to determine whether perceived motor competence or motor skill competence best predicts moderate-to-vigorous self-report physical activity. Multiple regression analysis indicated that motor skill competence and perceived motor competence predicted 21% variance in physical activity (R(2)=0.21, F=48.9, P=0.001), and motor skill competence (R(2)=0.15, ᵝ=0.33, P= 0.001) resulted in more variance than perceived motor competence (R(2)=0.06, ᵝ=0.25, P=0.001) in physical activity. Results revealed motor skill competence had more influence in comparison with perceived motor competence on physical activity level. We suggest interventional programs based on motor skill competence and perceived motor competence should be administered or implemented to promote physical activity in young girls.

  6. Do Pediatric Hematology/Oncology (PHO) Fellows Receive Communication Training?

    PubMed Central

    File, Wilson; Bylund, Carma L.; Kesselheim, Jennifer; Leonard, David; Leavey, Patrick

    2017-01-01

    Purpose The Accreditation Council for Graduate Medical Education (ACGME) has established communication as a core competency for physicians in training. However, data suggest that most pediatric residents perceive inadequate training in the delivery of bad news and the majority of former trainees in pediatric oncology received no formal training in the delivery of bad news during fellowship. The study examines communication training in ACGME accredited US pediatric hematology-oncology (PHO) fellowship programs. Methods An online survey was distributed to 315 PHO fellows in training via the American Society of Pediatric Hematology/Oncology (ASPHO) fellow email registry. Each fellow received an initial request to participate and 2 reminders, while participation was encouraged through a random incentive drawing. Results One hundred and ten fellows (35%) responded. Eighty percent of respondents perceived communication training to be important to fellow education, however only 32% reported receiving communication training (other than direct observation). The most common reported teaching method of fellowship communication training was formal lecture (42%). Twenty-three percent of respondents reported neither communication training nor frequent feedback on their communication skills from faculty observation. This same group was the least satisfied with their programs’ approach to teaching communication (P < 0.001). Conclusions There is limited communication training in PHO fellowships despite ACGME requirements and fellows’ interest in this training. Didactic learning remains the most frequently described training method, yet educational theory identifies the limitation of didactic lectures alone. Communication training employing novel teaching methods and emphasizing communication challenges identified by fellows should be developed and evaluated. PMID:24039096

  7. Practical Implications for an Effective Radiology Residency Quality Improvement Program for Milestone Assessment.

    PubMed

    Leddy, Rebecca; Lewis, Madelene; Ackerman, Susan; Hill, Jeanne; Thacker, Paul; Matheus, Maria; Tipnis, Sameer; Gordon, Leonie

    2017-01-01

    Utilization of a radiology resident-specific quality improvement (QI) program and curriculum based on the Accreditation Council for Graduate Medical Education (ACGME) milestones can enable a program's assessment of the systems-based practice component and prepare residents for QI implementation post graduation. This article outlines the development process, curriculum, QI committee formation, and resident QI project requirements of one institution's designated radiology resident QI program. A method of mapping the curriculum to the ACGME milestones and assessment of resident competence by postgraduate year level is provided. Sample projects, challenges to success, and lessons learned are also described. Survey data of current trainees and alumni about the program reveal that the majority of residents and alumni responders valued the QI curriculum and felt comfortable with principles and understanding of QI. The most highly valued aspect of the program was the utilization of a resident education committee. The majority of alumni responders felt the residency quality curriculum improved understanding of QI, assisted with preparation for the American Board of Radiology examination, and prepared them for QI in their careers. In addition to the survey results, outcomes of resident project completion and resident scholarly activity in QI are evidence of the success of this program. It is hoped that this description of our experiences with a radiology resident QI program, in accordance with the ACGME milestones, may facilitate the development of successful QI programs in other diagnostic radiology residencies. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  8. General Marketing. A Guide to Resources.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Vocational Instructional Materials Lab.

    This guide, which was written for general marketing instructors in Ohio, lists more than 600 resources for use in conjunction with the General Marketing Occupational Competency Analysis Profile. The texts, workbooks, modules, software, videos, and learning activities packets listed are categorized by the following topics: human resource…

  9. Teacher-Child Relationships and Social Competence: A Two-Year Longitudinal Study of Chinese Preschoolers

    ERIC Educational Resources Information Center

    Zhang, Xiao; Nurmi, Jari-Erik

    2012-01-01

    Based on a two-year and three-wave longitudinal sample of 118 Chinese preschoolers, the present study examined the cross-lagged associations between teacher-child relationships and social competence, and the cross-system generalization of social competence between home and school. At each of the three waves, teachers rated the children's…

  10. Higher specialty training in genitourinary medicine: A curriculum competencies-based approach.

    PubMed

    Desai, Mitesh; Davies, Olubanke; Menon-Johansson, Anatole; Sethi, Gulshan Cindy

    2018-01-01

    Specialty trainees in genitourinary medicine (GUM) are required to attain competencies described in the GUM higher specialty training curriculum by the end of their training, but learning opportunities available may conflict with service delivery needs. In response to poor feedback on trainee satisfaction surveys, a four-year modular training programme was developed to achieve a curriculum competencies-based approach to training. We evaluated the clinical opportunities of the new programme to determine: (1) Whether opportunity cost of training to service delivery is justifiable; (2) Which competencies are inadequately addressed by direct clinical opportunities alone and (3) Trainee satisfaction. Local faculty and trainees assessed the 'usefulness' of the new modular programme to meet each curriculum competence. The annual General Medical Council (GMC) national training survey assessed trainee satisfaction. The clinical opportunities provided by the modular training programme were sufficiently useful for attaining many competencies. Trainee satisfaction as captured by the GMC survey improved from two reds pre- to nine greens post-intervention on a background of rising clinical activity in the department. The curriculum competencies-based approach to training offers an objective way to balance training with service provision and led to an improvement in GMC survey satisfaction.

  11. General Practitioner Supervisor assessment and teaching of Registrars consulting with Aboriginal patients – is cultural competence adequately considered?

    PubMed Central

    2014-01-01

    Background General Practitioner (GP) Supervisors have a key yet poorly defined role in promoting the cultural competence of GP Registrars who provide healthcare to Aboriginal and Torres Strait Islander people during their training placements. Given the markedly poorer health of Indigenous Australians, it is important that GP training and supervision of Registrars includes assessment and teaching which address the well documented barriers to accessing health care. Methods A simulated consultation between a GP Registrar and an Aboriginal patient, which illustrated inadequacies in communication and cultural awareness, was viewed by GP Supervisors and Medical Educators during two workshops in 2012. Participants documented teaching points arising from the consultation which they would prioritise in supervision provided to the Registrar. Content analysis was performed to determine the type and detail of the planned feedback. Field notes from workshop discussions and participant evaluations were used to gain insight into participant confidence in cross cultural supervision. Results Sixty four of 75 GPs who attended the workshops participated in the research. Although all documented plans for detailed teaching on the Registrar’s generic communication and consultation skills, only 72% referred to culture or to the patient’s Aboriginality. Few GPs (8%) documented a plan to advise on national health initiatives supporting access for Aboriginal and Torres Strait Islander people. A lack of Supervisor confidence in providing guidance on cross cultural consulting with Aboriginal patients was identified. Conclusions The role of GP Supervisors in promoting the cultural competence of GP Registrars consulting with Aboriginal and Torres Strait Islander patients could be strengthened. A sole focus on generic communication and consultation skills may lead to inadequate consideration of the health disparities faced by Indigenous peoples and of the need to ensure Registrars utilise

  12. Regents Examinations & Competency Tests: School Administrator's Manual. 1983 Edition.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Bureau of Elementary and Secondary Testing Programs.

    Intended for use by school administrators, guidance counselors, teachers, and proctors, this manual contains general information on Regents examinations and competency tests. Specifically, the regulations and procedures for ordering, administering, rating, and reporting results of these examinations are described. Information is also included…

  13. [The use of operational criteria for evaluations of mental competency].

    PubMed

    Kocha, Hiroki

    2013-01-01

    Today, either the DSM-IV or the ICD-10 is generally used for forensic purposes, especially for evaluations of mental competency. The use of operational criteria, such as the DSM-IV, in forensic settings has some risks. Here, these risks, as well as the advantages of operational criteria and precautions for their use, are discussed. Compared with the DSM-IV, the ICD-10 is preferred because this tool is less likely to complicate evaluations of the mental status of a criminal at the time of the crime when sufficient information is not available to make a diagnosis. The evaluation consists of two steps. The first step, which is based on empirical science, is to provide a psychiatric diagnosis. The second step, which is based on normative science, is to allocate the diagnosis to one of four categories of a forensic frame of reference and to provide useful information for judicial members to make a judgment about the mental competency of the criminal. To standardize evaluations, the use of not only global standard criteria, but also a general rule for the judgment of mental competency within each allocated category is needed.

  14. Assessment of Teaching Competence for Improvement of Instruction.

    ERIC Educational Resources Information Center

    National IOTA Program, Tempe, AZ.

    This report provides a general overview of the Instrument for the Observation of Teaching Activities (IOTA) program for assessing and improving teacher competence. IOTA is an analytic, objective, and specific means of assessing teaching activities. The normal three-step progression of groups through the introductory and training stages of the…

  15. Characterization of competence and biofilm development of a Streptocccus sanguinis endocarditis isolate

    PubMed Central

    Zhu, Lin; Zhang, Yongshu; Fan, Jingyuan; Herzberg, Mark C.; Kreth, Jens

    2010-01-01

    Streptococcus sanguinis is an oral commensal bacterium and endogenous pathogen in the blood, which generally is naturally competent to take up extracellular DNA. Regarded as a stress response, competence development enables S. sanguinis to acquire new genetic material. The sequenced reference strain SK36 encodes and expresses the genes required for competence (com) and uptake of DNA. Isolated from blood cultures of a confirmed case of infective endocarditis, strain 133–79 encodes all necessary com genes but is not transformable under conditions permissive for competence development in SK36. Using synthetic competence-stimulating peptides (sCSP) based on sequences of SK36 and 133–79 comC, both strains developed competence at similar frequencies in cross-transformation experiments. Furthermore, downstream response pathways are similar in strains SK36 and 133–79 since platelet aggregation and biofilm formation appeared unaffected by CSP. Collectively, the data indicate that strains SK36 and 133–79 respond to CSP similarly, strongly suggesting that endogenous production or release of CSP from 133–79 is impaired. PMID:21375702

  16. Characterization of competence and biofilm development of a Streptococcus sanguinis endocarditis isolate.

    PubMed

    Zhu, L; Zhang, Y; Fan, J; Herzberg, M C; Kreth, J

    2011-04-01

    Streptococcus sanguinis is an oral commensal bacterium and endogenous pathogen in the blood, which is generally naturally competent to take up extracellular DNA. Regarded as a stress response, competence development enables S. sanguinis to acquire new genetic material. The sequenced reference strain SK36 encodes and expresses the genes required for competence (com) and uptake of DNA. Isolated from blood cultures of a confirmed case of infective endocarditis, strain 133-79 encodes all necessary com genes but is not transformable under conditions permissive for competence development in SK36. Using synthetic competence-stimulating peptides (sCSP) based on sequences of SK36 and 133-79 comC, both strains developed competence at similar frequencies in cross-transformation experiments. Furthermore, downstream response pathways are similar in strains SK36 and 133-79 because platelet aggregation and biofilm formation appeared unaffected by CSP. Collectively, the data indicate that strains SK36 and 133-79 respond to CSP similarly, strongly suggesting that endogenous production or release of CSP from 133-79 is impaired. © 2011 John Wiley & Sons A/S.

  17. Motor Skill Competence and Perceived Motor Competence: Which Best Predicts Physical Activity among Girls?

    PubMed Central

    Khodaverdi, Zeinab; Bahram, Abbas; Khalaji, Hassan; Kazemnejad, Anoshirvan

    2013-01-01

    Abstract Background The main purpose of this study was to determine which correlate, perceived motor competence or motor skill competence, best predicts girls’ physical activity behavior. Methods A sample of 352 girls (mean age=8.7, SD=0.3 yr) participated in this study. To assess motor skill competence and perceived motor competence, each child completed the Test of Gross Motor Development-2 and Physical Ability sub-scale of Marsh’s Self-Description Questionnaire. Children’s physical activity was assessed by the Physical Activity Questionnaire for Older Children. Multiple linear regression model was used to determine whether perceived motor competence or motor skill competence best predicts moderate-to-vigorous self-report physical activity. Results Multiple regression analysis indicated that motor skill competence and perceived motor competence predicted 21% variance in physical activity (R2=0.21, F=48.9, P=0.001), and motor skill competence (R2=0.15, ᵝ=0.33, P= 0.001) resulted in more variance than perceived motor competence (R2=0.06, ᵝ=0.25, P=0.001) in physical activity. Conclusion Results revealed motor skill competence had more influence in comparison with perceived motor competence on physical activity level. We suggest interventional programs based on motor skill competence and perceived motor competence should be administered or implemented to promote physical activity in young girls. PMID:26060623

  18. Impact of an Event Reporting System on Resident Complication Reporting in Plastic Surgery Training: Addressing an ACGME and Plastic Surgery Milestone Project Core Competency.

    PubMed

    Parikh, Rajiv P; Snyder-Warwick, Alison; Naidoo, Sybill; Skolnick, Gary B; Patel, Kamlesh B

    2017-11-01

    The Accreditation Council for Graduate Medical Education and Plastic Surgery Milestone Project has identified practice-based learning and improvement, which involves systematically analyzing current practices and implementing changes, as a core competency in residency education. In surgical care, complication reporting is an essential component of practice-based learning and improvement as complications are analyzed in morbidity and mortality conference for quality improvement. Unfortunately, current methods for capturing a comprehensive profile of complications may significantly underestimate the true occurrence of complications. Therefore, the objectives of this study are to evaluate an intervention for complication reporting and compare this to current practice, in a plastic surgery training program. This is a preintervention and postintervention study evaluating resident reporting of complications on a plastic surgery service. The intervention was an online event reporting system developed by department leadership and patient safety experts. The cohorts consisted of all patients undergoing surgery during two separate 3-month blocks bridged by an implementation period. A trained reviewer recorded complications, and this served as the reference standard. Fisher's exact test was used for binary comparisons. There were 32 complications detected in 219 patients from June to August of 2015 and 35 complications in 202 patients from October to December of 2015. The proportion of complications reported in the preintervention group was nine of 32 (28.1 percent). After the intervention, this significantly increased to 32 of 35 (91.4 percent) (p < 0.001). An intervention using an event reporting system, supported by departmental leadership, led to significant improvements in complication reporting by plastic surgery residents.

  19. Competence formation and post-graduate education in the public water sector in Indonesia

    NASA Astrophysics Data System (ADS)

    Kaspersma, J. M.; Alaerts, G. J.; Slinger, J. H.

    2012-07-01

    The water sector is dependent on effective institutions and organisations, and, therefore, on strong competences at the individual level. In this paper we describe competence formation and competence needs in a case study of the Directorate General of Water Resources (DGWR) in the Ministry of Public Works in Indonesia. A framework is introduced for the water sector comprising three aggregate competences for technical issues, management, and governance, and a meta-competence for continuous learning and innovation. The four competences are further organised in a T-shaped competence profile. Though DGWR professionals have a firmly "technical" orientation, both surveys and interviews reveal a strong perceived requirement for other competences: in particular the learning meta-competence, as well as the aggregate competence for management. The aggregate competence for governance systematically scores lower. Further, a discrepancy appears to exist between the competences that staff perceive as needed in daily work, and those that can be acquired during post-graduate water education. In both locally-based and international post-graduate water education, the aggregate competences for management as well as governance are reportedly addressed modestly, if at all. With low competence in these fields, it is difficult for professionals to communicate and collaborate effectively in a multidisciplinary way. As a result, the horizontal bar of the T-shaped profile remains weakly developed. In international post-graduate education, this is partially compensated by the attention to continuous learning and innovation. The exposure to a different culture and learning format is experienced as fundamentally formative.

  20. Future orientation and competence to stand trial: the fragility of competence.

    PubMed

    Kivisto, Aaron J; Moore, Todd M; Fite, Paula A; Seidner, Bruce G

    2011-01-01

    The current study examined the direct, indirect, and interactive effects of age, intellectual ability, psychiatric symptomatology, and future orientation on juvenile adjudicative competence utilizing a secondary sample of 927 youth from the MacArthur Juvenile Adjudicative Competence Study. Consistent with previous research, age, intellectual ability, and future orientation were found to be positively associated with competence, and psychiatric symptomatology was weakly negatively related to competence. Tests of indirect effects revealed that the development of an orientation toward future consequences partially explains the relationship between age and the capacity to reason about legal decision-making. Further, tests of invariance revealed that the competence of immature adolescents is particularly "fragile," in that smaller deficits in cognitive abilities appear to pose greater problems in youths regarding their adjudicative competence than in their more mature peers. Findings are discussed in regard to forensic practice as well as for future research.

  1. Association between selected physical fitness parameters and esthetic competence in contemporary dancers.

    PubMed

    Angioi, Manuela; Metsios, George S; Twitchett, Emily; Koutedakis, Yiannis; Wyon, Matthew

    2009-01-01

    The physical demands imposed on contemporary dancers by choreographers and performance schedules make their physical fitness just as important to them as skill development. Nevertheless, it remains to be confirmed which physical fitness components are associated with aesthetic competence. The aim of this study was to: 1. replicate and test a novel aesthetic competence tool for reliability, and 2. investigate the association between selected physical fitness components and aesthetic competence by using this new tool. Seventeen volunteers underwent a series of physical fitness tests (body composition, flexibility, muscular power and endurance, and aerobic capacity) and aesthetic competence assessments (seven individual criteria commonly used by selected dance companies). Inter-rater reliability of the aesthetic competence tool was very high (r = 0.96). There were significant correlations between the aesthetic competence score and jump ability and push-ups (r = 0.55 and r = 0.55, respectively). Stepwise backward multiple regression analysis revealed that the best predictor of aesthetic competence was push-ups (R(2) = 0.30, p = 0.03). Univariate analyses also revealed that the interaction of push-ups and jump ability improved the prediction power of aesthetic competence (R(2) = 0.44, p = 0.004). It is concluded that upper body muscular endurance and jump ability best predict aesthetic competence of the present sample of contemporary dancers. Further research is required to investigate the contribution of other components of aesthetic competence, including upper body strength, lower body muscular endurance, general coordination, and static and dynamic balance.

  2. [Competencies of the nurse in the management of cognitive and capital knowledge].

    PubMed

    Ruthes, Rosa Maria; Cunha, Isabel Cristina Kowal Olm

    2009-01-01

    The article presents a review of nurse's management competencies and the practical management of knowledge and the human capital and the applicability of the management for competencies. Globalization and competitiveness makes health organizations to search adaptative forms to the transformations of the management. For the nurse it is expected to consider solutions nursing team related to health organizations problems. The management of the intellectual capital must take care that the personnel is applying the knowing in benefit of the organization and the professional growth. If it will not have necessary competences for generalized application of knowledge, this is useless. The nurses must be prepared to evaluate technological, organizational and human resources and to develop competencies, knowledge, abilities, attitudes, and values to plan, to organize, to direct, to control the knowledge in the organizations.

  3. Role of general and specific competence skills in protecting inner-city adolescents from alcohol use.

    PubMed

    Epstein, J A; Griffin, K W; Botvin, G J

    2000-05-01

    The purpose of this longitudinal investigation was to test whether higher levels of general competence are linked to greater refusal assertiveness that is, in turn, related to less subsequent alcohol use among inner-city adolescents. A large sample of students attending 22 middle and junior high schools in New York City participated. Students completed surveys at baseline, at 1-year follow-up and at 2-year follow-up (N = 1,459; 54% female). The students self-reported alcohol use. decision-making skills, self-efficacy and refusal assertiveness. Teams of three to five data collectors administered the questionnaire following a standardized protocol. The data were collected in school during a regular 40-minute class period. According to the tested structural equation model, Decision Making (beta = .07, p < .05) and Self-Efficacy (beta = .24, p < .001) predicted higher Refusal Assertiveness and this greater assertiveness predicted less drinking at the 2-year follow-up (beta = -.21, p < .001). Earlier drinking predicted 2-year follow-up drinking (beta = .40, p < .001). Goodness-of-fit indices were excellent (chi2 = 1107.9, 238 df, N = 1,438, p < .001; NFI = .93, NNFI = .94, CFI = .95). The tested model had a good fit and was parsimonious and consistent with theory. This research highlights the importance of addressing decision-making skills, self-efficacy and refusal assertiveness within adolescent alcohol prevention programs.

  4. Acculturation Conflict, Cultural Parenting Self-Efficacy, and Perceived Parenting Competence in Asian American and Latino/a Families.

    PubMed

    Kiang, Lisa; Glatz, Terese; Buchanan, Christy M

    2017-12-01

    Parents from immigrant backgrounds must deal with normative parenting demands as well as unique challenges associated with acculturation processes. The current study examines the independent and interactive influences of acculturation conflict and cultural parenting self-efficacy (PSE; e.g., parents' confidence in instilling heritage, American, and bicultural values in their children) on perceptions of general parenting competence. Using data from 58 Asian American and 153 Latin American parents of children in grades 6-12, ethnic differences were also explored. Results suggest that lower acculturation conflict is associated with higher perceptions of general parenting competence for both Asian and Latin American parents. Higher cultural PSE is associated with higher perceived general parenting competence for Latino/a parents only. One significant interaction was found, and only for Asian Americans, whereby the negative association between acculturation conflict and perceptions of parenting competence was weaker for those who felt efficacious in transmitting heritage messages. Results are discussed in light of clinical implications and the need for further recognition and study of culturally relevant factors and frameworks among families from immigrant backgrounds. © 2016 Family Process Institute.

  5. Children's selective trust decisions: rational competence and limiting performance factors.

    PubMed

    Hermes, Jonas; Behne, Tanya; Bich, Anna Elisa; Thielert, Christa; Rakoczy, Hannes

    2018-03-01

    Recent research has amply documented that even preschoolers learn selectively from others, preferring, for example, reliable over unreliable and competent over incompetent models. It remains unclear, however, what the cognitive foundations of such selective learning are, in particular, whether it builds on rational inferences or on less sophisticated processes. The current study, therefore, was designed to test directly the possibility that children are in principle capable of selective learning based on rational inference, yet revert to simpler strategies such as global impression formation under certain circumstances. Preschoolers (N = 75) were shown pairs of models that either differed in their degree of competence within one domain (strong vs. weak or knowledgeable vs. ignorant) or were both highly competent, but in different domains (e.g., strong vs. knowledgeable model). In the test trials, children chose between the models for strength- or knowledge-related tasks. The results suggest that, in fact, children are capable of rational inference-based selective trust: when both models were highly competent, children preferred the model with the competence most predictive and relevant for a given task. However, when choosing between two models that differed in competence on one dimension, children reverted to halo-style wide generalizations and preferred the competent models for both relevant and irrelevant tasks. These findings suggest that the rational strategies for selective learning, that children master in principle, can get masked by various performance factors. © 2017 John Wiley & Sons Ltd.

  6. Management and leadership competence in hospitals: a systematic literature review.

    PubMed

    Pihlainen, Vuokko; Kivinen, Tuula; Lammintakanen, Johanna

    2016-01-01

    Purpose - The purpose of this study is to describe the characteristics of management and leadership competence of health-care leaders and managers, especially in the hospital environment. Health-care leaders and managers in this study were both nursing and physician managers. Competence was assessed by evaluating the knowledge, skills, attitudes and abilities that enable management and leadership tasks. Design/methodology/approach - A systematic literature review was performed to find articles that identify and describe the characteristics of management and leadership competence. Searches of electronic databases were conducted using set criteria for article selection. Altogether, 13 papers underwent an inductive content analysis. Findings - The characteristics of management and leadership competence were categorized into the following groups: health-care-context-related, operational and general. Research limitations/implications - One limitation of the study is that only 13 articles were found in the literature regarding the characteristics of management and leadership competence. However, the search terms were relevant, and the search process was endorsed by an information specialist. The study findings imply the need to shift away from the individual approach to leadership and management competence. Management and leadership need to be assessed more frequently from a holistic perspective, and not merely on the basis of position in the organizational hierarchy or of profession in health care. Originality/value - The authors' evaluation of the characteristics of management and leadership competence without a concentrated profession-based approach is original.

  7. Performance of Handicapped Students in a Competency Testing Program.

    ERIC Educational Resources Information Center

    Serow, Robert C.; O'Brien, Kathleen

    1983-01-01

    Samples of handicapped and nonhandicapped pupils were compared on the following: initial Minimum Competency Test (MCT) performance, participation in remediation, improvements in subsequent MCT, and eligibility for receiving high school diplomas. Nonhandicapped pupils generally fared better on all measures, although sharp differences were found…

  8. Cultural competence springs up in the desert: the story of the center for cultural competence in health care at Weill Cornell Medical College in Qatar.

    PubMed

    Elnashar, Maha; Abdelrahim, Huda; Fetters, Michael D

    2012-06-01

    The authors describe the factors that led Weill Cornell Medical College in Qatar (WCMC-Q) to establish the Center for Cultural Competence in Health Care from the ground up, and they explore challenges and successes in implementing cultural competence training.Qatar's capital, Doha, is an extremely high-density multicultural setting. When WCMC-Q's first class of medical students began their clinical clerkships at the affiliated teaching hospital Hamad Medical Corporation in 2006, the complicated nature of training in a multicultural and multilingual setting became apparent immediately. In response, initiatives to improve students' cultural competence were undertaken. Initiatives included launching a medical interpretation program in 2007; surveying the patients' spoken languages, examining the effect of an orientation program on interpretation requests, and surveying faculty using the Tool for Assessing Cultural Competence Training in 2008; implementing cultural competence training for students and securing research funding in 2009; and expanding awareness to the Qatar community in 2010. These types of initiatives, which are generally highly valued in U.S. and Canadian settings, are also apropos in the Arabian Gulf region.The authors report on their initial efforts, which can serve as a resource for other programs in the Arabian Gulf region.

  9. Accreditation Council for Graduate Medical Education accreditation and influence on perceptions of pediatric otolaryngology fellowship training experience.

    PubMed

    Bedwell, Joshua R; Choi, Sukgi; Chan, Kenny; Preciado, Diego

    2013-09-01

    The American Society of Pediatric Otolaryngology (ASPO) has set a goal of universal accreditation of fellowship programs by the Accreditation Council for Graduate Medical Education (ACGME) by 2014. This study offers data comparing trainee experience at accredited vs nonaccredited programs. To evaluate perceptions of pediatric otolaryngology fellowship training experience and to elucidate differences between those who trained in ACGME-accredited fellowships vs those who did not. Web-based survey sent to all members of ASPO, as well as recent fellowship graduate ASPO-eligible physicians. Responses were obtained in an anonymous fashion. The study population comprised 136 ASPO members who recently graduated from pediatric otolaryngology fellowship programs (36 from ACGME-accredited fellowships and 100 from nonaccredited programs). Difference in perceived fellowship experience between graduates of accredited vs nonaccredited programs, specifically, differences in service vs education perceptions. Overall, a majority (64%) of respondents agreed that standardizing the pediatric fellowship curriculum through ACGME accreditation is a worthwhile goal. Those who attended ACGME-accredited fellowships were more likely to favor accreditation vs non-ACGME graduates (83% vs 58%; P = .006). Graduates of ACGME-accredited programs were also more likely to agree that their fellowship provided adequate preparation for a career in academic medicine (100% vs 89%; P = .04), protected time for research (94% vs 60%; P < .001), vacation and academic time (94% vs 78%; P = .03), and opportunities to formally evaluate their superiors (72% vs 32%; P < .001). Non-ACGME graduates reported higher primary call frequency (0.8 days per week vs 0.2 days per week; P = .01), and attending physician participation in rounds (71% vs 53%; P = .05). Most respondents were in agreement with universal ACGME accreditation. Those having trained in accredited programs cite increased

  10. Competences for All: Recognizing and Developing Competences of Young People with Fewer Opportunities

    ERIC Educational Resources Information Center

    Usakli, Hakan

    2016-01-01

    This qualitative study clarifies opinion of 32 European volunteer youth leaders on concepts of competence, fewer opportunities and enlargement strategies on competence of fewer opportunities. Leaders underline main competencies as follows: tongue, languages, mathematical, digital, learning, social, entrepreneurship, cultural. Key competences are…

  11. Developing Intercultural Competence in University Staff: Augmenting Internationalisation

    ERIC Educational Resources Information Center

    Andrew, Helen

    2012-01-01

    The primary aim of this research was to consider the benefit of providing professional development in intercultural competence for general staff at Deakin University. While the question arose from a disparity identified in the University policies, the importance of this consideration was highlighted in an impending audit to be conducted by AUQA,…

  12. Can One Undergraduate Course Increase Cross-Cultural Competence?

    ERIC Educational Resources Information Center

    Spitzer, Lois

    2015-01-01

    The majority of students who took this general education undergraduate course in developing cross-cultural understanding at a state college in the northeastern United States reported that their level of cross-cultural competence and global awareness increased by the end of the course. The primary course objective was to help students better…

  13. Competencies for the 21st Century Information Professional: Translating the SLA Competencies into Business Competencies.

    ERIC Educational Resources Information Center

    Henczel, Sue

    This paper examines how the Special Libraries Association competencies can be mapped to the broader business competencies of marketing (promoting), packaging (product development), persuading and performing (sales/customer service), and positioning (strategic maneuvering). It introduces a process whereby the skills, knowledge, understandings, and…

  14. A students' survey of cultural competence as a basis for identifying gaps in the medical curriculum.

    PubMed

    Seeleman, Conny; Hermans, Jessie; Lamkaddem, Majda; Suurmond, Jeanine; Stronks, Karien; Essink-Bot, Marie-Louise

    2014-10-11

    Assessing the cultural competence of medical students that have completed the curriculum provides indications on the effectiveness of cultural competence training in that curriculum. However, existing measures for cultural competence mostly rely on self-perceived cultural competence. This paper describes the outcomes of an assessment of knowledge, reflection ability and self-reported culturally competent consultation behaviour, the relation between these assessments and self-perceived cultural competence, and the applicability of the results in the light of developing a cultural competence educational programme. 392 medical students, Youth Health Care (YHC) Physician Residents and their Physician Supervisors were invited to complete a web-based questionnaire that assessed three domains of cultural competence: 1) general knowledge of ethnic minority care provision and interpretation services; 2) reflection ability; and 3) culturally competent consultation behaviour. Additionally, respondents graded their overall self-perceived cultural competence on a 1-10 scale. 86 medical students, 56 YHC Residents and 35 YHC Supervisors completed the questionnaire (overall response rate 41%; n= 177). On average, respondents scored low on general knowledge (mean 46% of maximum score) and knowledge of interpretation services (mean 55%) and much higher on reflection ability (80%). The respondents' reports of their consultation behaviour reflected moderately adequate behaviour in exploring patients' perspectives (mean 64%) and in interaction with low health literate patients (mean 60%) while the score on exploring patients' social contexts was on average low (46%). YHC respondents scored higher than medical students on knowledge of interpretation services, exploring patients' perspectives and exploring social contexts. The associations between self-perceived cultural competence and assessed knowledge, reflection ability and consultation behaviour were weak. Assessing the cultural

  15. Sexual Health Competencies for Undergraduate Medical Education in North America.

    PubMed

    Bayer, Carey Roth; Eckstrand, Kristen L; Knudson, Gail; Koehler, Jean; Leibowitz, Scott; Tsai, Perry; Feldman, Jamie L

    2017-04-01

    The number of hours spent teaching sexual health content and skills in medical education continues to decrease despite the increase in sexual health issues faced by patients across the lifespan. In 2012 and 2014, experts across sexuality disciplines convened for the Summits on Medical School Education and Sexual Health to strategize and recommend approaches to improve sexual health education in medical education systems and practice settings. One of the summit recommendations was to develop sexual health competencies that could be implemented in undergraduate medical education curricula. To discuss the process of developing sexual health competencies for undergraduate medical education in North America and present the resulting competencies. From 2014 to 2016, a summit multidisciplinary subcommittee met through face-to-face, phone conference, and email meetings to review prior competency-based guidelines and then draft and vet general sexual health competencies for integration into undergraduate medical school curricula. The process built off the Association of American Medical Colleges' competency development process for training medical students to care for lesbian, gay, bisexual, transgender, and gender non-conforming patients and individuals born with differences of sex development. This report presents the final 20 sexual health competencies and 34 qualifiers aligned with the 8 overall domains of competence. Development of a comprehensive set of sexual health competencies is a necessary first step in standardizing learning expectations for medical students upon completion of undergraduate training. It is hoped that these competencies will guide the development of sexual health curricula and assessment tools that can be shared across medical schools to ensure that all medical school graduates will be adequately trained and comfortable addressing the different sexual health concerns presented by patients across the lifespan. Bayer CR, Eckstrand KL, Knudson G, et

  16. Beyond NAVMEC: competency-based veterinary education and assessment of the professional competencies.

    PubMed

    Hodgson, Jennifer L; Pelzer, Jacquelyn M; Inzana, Karen D

    2013-01-01

    The implementation of competency-based curricula within the health sciences has been an important paradigm shift over the past 30 years. As a result, one of the five strategic goals recommended by the North American Veterinary Medical Education Consortium (NAVMEC) report was to graduate career-ready veterinarians who are proficient in, and have the confidence to use, an agreed-upon set of core competencies. Of the nine competencies identified as essential for veterinary graduates, seven could be classified as professional or non-technical competencies: communication; collaboration; management (self, team, system); lifelong learning, scholarship, value of research; leadership; diversity and multicultural awareness; and adaptation to changing environments. Traditionally, the professional competencies have received less attention in veterinary curricula and their assessment is often sporadic or inconsistent. In contrast, the same or similar competencies are being increasingly recognized in other health professions as essential skills and abilities, and their assessment is being undertaken with enhanced scrutiny and critical appraisal. Several challenges have been associated with the assessment of professional competencies, including agreement as to their definition and therefore their evaluation, the fact that they are frequently complex and require multiple integrative assessments, and the ability and/or desire of faculty to teach and assess these competencies. To provide an improved context for assessment of the seven professional competencies identified in the NAVMEC report, this article describes a broad framework for their evaluation as well as specific examples of how these or similar competencies are currently being measured in medical and veterinary curricula.

  17. Operative volume in the new era: a comparison of resident operative volume before and after implementation of 80-hour work week restrictions.

    PubMed

    Bruce, Pamela J; Helmer, Stephen D; Osland, Jacqueline S; Ammar, Alex D

    2010-01-01

    To determine the effect of the 80-hour work week restrictions on general surgery resident operative volume in a large, community-based, university-affiliated, general surgery residency program. We performed a retrospective review of Accreditation Council for Graduate Medical Education (ACGME) operative logs of general surgery residents graduating from a single residency. The control group consisted of the residents graduating in the 3 years prior to the work-hour restriction implementation (2001, 2002, and 2003). Our comparison group consisted of those residents graduating in the first 2 classes whose entire residency was conducted after the implementation of the 80-hour work week (2008 and 2009). Comparisons were made between the control and the comparison groups in the 19 ACGME defined categories, total number of major cases, total number of chief cases, and total number of teaching assist cases. Operative volumes in 13 categories (skin/soft tissue/breast, alimentary tract, abdominal, liver, pancreas, vascular, endocrine, pediatrics, endoscopy, laparoscopic-complex, total chief cases, total major cases, and teaching cases) were not significantly affected by the implementation of the 80-hour work week. One of the 19 categories (laparoscopic-basic) showed a significant increase in operative volume (p < 0.0001). In 4 of the 19 categories (head/neck, operative-trauma, thoracic, and plastics), operative volume was significantly decreased in the post-80-hour work week era (p < 0.05). Nonoperative trauma could not be assessed, as the category did not exist before the work-hour restrictions. Resident operative volume at our institution's general surgery residency program largely has been unaffected by implementation of the 80-hour work week. Residencies in general surgery can be structured in a manner to allow for compliance with duty-hour regulations while maintaining the required operative volume outlined by the ACGME defined categories. Copyright © 2010 Association

  18. Competency Maps: an Effective Model to Integrate Professional Competencies Across a STEM Curriculum

    NASA Astrophysics Data System (ADS)

    Sánchez Carracedo, Fermín; Soler, Antonia; Martín, Carme; López, David; Ageno, Alicia; Cabré, Jose; Garcia, Jordi; Aranda, Joan; Gibert, Karina

    2018-05-01

    Curricula designed in the context of the European Higher Education Area need to be based on both domain-specific and professional competencies. Whereas universities have had extensive experience in developing students' domain-specific competencies, fostering professional competencies poses a new challenge we need to face. This paper presents a model to globally develop professional competencies in a STEM (science, technology, engineering, and mathematics) degree program, and assesses the results of its implementation after 4 years. The model is based on the use of competency maps, in which each competency is defined in terms of competency units. Each competency unit is described by a set of expected learning outcomes at three domain levels. This model allows careful analysis, revision, and iteration for an effective integration of professional competencies in domain-specific subjects. A global competency map is also designed, including all the professional competency learning outcomes to be achieved throughout the degree. This map becomes a useful tool for curriculum designers and coordinators. The results were obtained from four sources: (1) students' grades (classes graduated from 2013 to 2016, the first 4 years of the new Bachelor's Degree in Informatics Engineering at the Barcelona School of Informatics); (2) students' surveys (answered by students when they finished the degree); (3) the government employment survey, where former students evaluate their satisfaction of the received training in the light of their work experience; and (4) the Everis Foundation University-Enterprise Ranking, answered by over 2000 employers evaluating their satisfaction regarding their employees' university training, where the Barcelona School of Informatics scores first in the national ranking. The results show that competency maps are a good tool for developing professional competencies in a STEM degree.

  19. Corps G-2 Staff Competencies: A Desert Storm Case Study

    DTIC Science & Technology

    2017-06-09

    processing and exploiting new information or produce updated analytic products for dissemination. 43 Intelligence Operations The corps directs IO by...CORPS G-2 STAFF COMPETENCIES: A DESERT STORM CASE STUDY A thesis presented to the Faculty of the US Army Command and General Staff...College in partial fulfillment of the requirements for the degree MASTER OF MILITARY ART AND SCIENCE General Studies by ERIK W

  20. Competencies for disaster mental health.

    PubMed

    King, Richard V; Burkle, Frederick M; Walsh, Lauren E; North, Carol S

    2015-03-01

    Competencies for disaster mental health are essential to domestic and international disaster response capabilities. Numerous consensus-based competency sets for disaster health workers exist, but no prior study identifies and discusses competency sets pertaining specifically to disaster mental health. Relevant competency sets were identified via MEDLINE, PsycINFO, EBSCO, and Google Scholar searches. Sixteen competency sets are discussed, some providing core competencies for all disaster responders and others for specific responder groups within particular professions or specialties. Competency sets specifically for disaster mental health professionals are lacking, with the exception of one set that focused only on cultural competence. The identified competency sets provide guidance for educators in developing disaster mental health curricula and for disaster health workers seeking education and training in disaster mental health. Valid, criterion-based competencies are required to guide selection and training of mental health professionals for the disaster mental health workforce. In developing these competencies, consideration should be given to the requirements of both domestic and international disaster response efforts.

  1. A cadaveric procedural anatomy course enhances operative competence.

    PubMed

    Sharma, Gaurav; Aycart, Mario A; Najjar, Peter A; van Houten, Trudy; Smink, Douglas S; Askari, Reza; Gates, Jonathan D

    2016-03-01

    Inadequate anatomy training has been cited as a major contributor to declines in surgical resident operative competence and confidence. We report the impact of a procedurally oriented general surgery cadaveric dissection course on trainee-operative confidence and competence. After obtaining institutional review board approval, postgraduate year 2 and 3 general surgery residents were prospectively enrolled into two cohorts: (1) an intervention group (n = 7) participating in an 8-wk procedurally oriented cadaver course and (2) controls (n = 7) given access to course materials without participation in cadaver dissection. At both the beginning and end of the study, we used two evaluation instruments: (1) an oral examination using standardized templates and (2) a questionnaire assessing operative confidence. There were no intergroup differences in baseline characteristics, including number of operative procedures performed to date. Residents who took the anatomy course had significantly higher improvements in examination scores on common bile duct exploration (mean ± standard error, 33 ± 8% versus 10 ± 7%, P = 0.04), femoral endarterectomy (43 ± 5% versus 11 ± 7%, P = 0.003), fasciotomies (55 ± 10% versus 22 ± 9%, P = 0.04), inguinal hernia repair (20 ± 9% versus -14 ± 5%, P = 0.005), superior mesenteric artery embolectomy (38 ± 10% versus 2 ± 11%, P = 0.04), and in overall examination scores (31 ± 4% versus 8% ± 3%, P = 0.0006). In addition, they reported higher operative confidence on common bile duct exploration (P = 0.008) and superior mesenteric artery embolectomy (P = 0.02), and a trend toward higher overall operative confidence (P = 0.06). In this study, we demonstrate that a procedurally oriented cadaver course covering a wide range of essential general surgery procedures resulted in significant improvements in self-reported operative confidence and competence as assessed by oral examination. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Examining Perception of Competency through Practicum Competencies Outline

    ERIC Educational Resources Information Center

    Esposito, Giovanna; Freda, Maria Francesca; Bosco, Valentina

    2015-01-01

    Purpose: This study aims to examine the self-perceived competencies of 231 Italian students enrolled in a psychological degree program and involved in a practicum. It analyzes the subjective perception of the competences that students expect to develop, acknowledge as developed and that might be inferred from tasks performed during the practicum;…

  3. Resident operative experience in general surgery, plastic surgery, and urology 5 years after implementation of the ACGME duty hour policy.

    PubMed

    Simien, Christopher; Holt, Kathleen D; Richter, Thomas H; Whalen, Thomas V; Coburn, Michael; Havlik, Robert J; Miller, Rebecca S

    2010-08-01

    Resident duty hour restrictions were implemented in 2002-2003. This study examines changes in resident surgical experience since these restrictions were put into place. Operative log data for 3 specialties were examined: general surgery, urology, and plastic surgery. The academic year immediately preceding the duty hour restrictions, 2002-2003, was used as a baseline for comparison to subsequent academic years. Operative log data for graduating residents through 2007-2008 were the primary focus of the analysis. Examination of associated variables that may moderate the relationship between fewer duty hours and surgical volume was also included. Plastic surgery showed no changes in operative volume following duty hour restrictions. Operative volume increased in urology programs. General surgery showed a decrease in volume in some operative categories but an increase in others. Specifically the procedures in vascular, plastic, and thoracic areas showed a consistent decrease. There was no increase in the percentage of programs' graduates falling below minimum requirements. Procedures in pancreas, endocrine, and laparoscopic areas demonstrated an increase in volume. Graduates in larger surgical programs performed fewer procedures than graduates in smaller programs; this was not the case for urology or plastic surgery programs. The reduction of duty hours has not resulted in an across the board decrease in operative volume. Factors other than duty hour reforms may be responsible for some of the observed findings.

  4. Proposal for a university-community-hospice partnership to address organizational barriers to cultural competence.

    PubMed

    Reese, Dona J

    2011-02-01

    Models of culturally competent hospice services have been developed, but they are not generally being used. This article describes a participatory action research project which is addressing organizational barriers to cultural competence through a university-community-hospice partnership. The intervention plan is to develop a connection with the African American community, increasing community knowledge, and hospice staff cultural competence through a social work student field placement. It is hoped that, if successful, this model will be replicated to address the problem of African American utilization and access to hospice.

  5. Contextualizing Competence: Language and LGBT-Based Competency in Health Care.

    PubMed

    Rossi, Alexis L; Lopez, Eliot J

    2017-01-01

    Changes in the language and terminology used to refer to individuals identifying as lesbian, gay, bisexual, and transgender (LGBT), as well as how best to discuss issues of sexual and gender identity, can prove challenging for health care providers due to (1) lack of training; (2) interdisciplinary issues; and (3) prejudices on personal and institutional levels. Given the importance of language in the relationship between health care provider and patient as well as the myriad ways in which language can reflect knowledge, skills, and attitudes, we contend that language is both a facilitator and inhibitor of competence. In this article, we discuss language as a means of exhibiting cultural competence as well as the barriers to facilitating this degree of competence. Communicative competence, a concept traditionally used in linguistics, is discussed as a framework for contextualizing LGBT-specific cultural competence in health care. Ideally, a professional will be considered competent once they (1) acquire a foundation in issues associated with LGBT individuals, as well as a basic understanding of appropriate vocabulary' (2) reconcile personal beliefs with their professional role; (3) create an inclusive healthcare environment such that the influence of personal biases does not negatively impact care; and (4) use identifiers suggested by the patient.

  6. Comparison of rational pharmacotherapy decision-making competence of general practitioners with intern doctors.

    PubMed

    Akici, A; Kalaça, S; Gören, M Z; Akkan, A G; Karaalp, A; Demir, D; Uğurlu, U; Oktay, S

    2004-04-01

    The aim of this study was to compare rational pharmacotherapy decision-making competency of interns (final-year medical students) who had received rational pharmacotherapy education (RPE), with their classmates at another medical school and general practitioners (GPs) who had not been exposed to RPE. A written, objective, structured clinical examination (OSCE), consisting of open and structured questions, was given to all participants. The participants were expected to make a treatment plan and prescribe for simple, uncomplicated beta-hemolytic streptococcal tonsillitis and mild-to-moderate essential hypertension patients, explain their proposed treatment plans and reasons affecting their drug choice. After the OSCE, a questionnaire to assess knowledge of the rational use of drugs was given to the participants. Fifty RPE(+) interns, 54 RPE(-) interns and 53 GPs participated in the study. Mean scores of RPE(+) interns were higher than those of GPs, which were in turn found to be higher than those of RPE(-) interns for all cases. The RPE(+) interns scored the highest regarding all components of rational pharmacotherapy process for all cases of both indications. However, participants in all groups had higher scores for the structured questions compared with the corresponding open ones for both diseases. Prescription analysis also revealed better results for RPE(+) interns regarding the number of drugs/prescription and treatment costs. The present study demonstrated that the final-year medical students (interns) markedly benefited from undergraduate RPE at the medical school in developing rational prescribing skills compared with their classmates from a medical school with traditional pharmacology education. Interestingly, they got higher scores than not only RPE(-) interns, but also than the GPs participating in this study, indicating the urgent need for continuous medical education programs in this field throughout the country for practicing GPs.

  7. A systematic review of the literature about competence and poor insight.

    PubMed

    Ruissen, A M; Widdershoven, G A M; Meynen, G; Abma, T A; van Balkom, A J L M

    2012-02-01

      Formally, incompetence implies that a patient cannot meet the legal requirements for informed consent. Our aim was to review the scientific literature on the relationship between competence and insight in patients with psychiatric disorders, how competence and insight are connected in these patients and whether there are differences in competence and insight among patients with different disorders.   A search in PubMed/Medline was performed. Articles were assessed on relevance criteria by two independent reviewers. Study design, population, variables, and outcomes were extracted.   Seven articles were included on studies of psychiatric inpatients and outpatients and of psychotic and non-psychotic patients. All studies used the MacArthur Competence Assessment Tool (MacCAT). All studies but one found a strong correlation between poor insight and incompetence. Psychotic patients with poor insight are very likely to be incompetent, and psychotic patients with adequate insight are generally competent. One well-executed study showed that in non-psychotic disorders, however, another relationship emerges; competence and insight do not completely overlap in these patients.   Most incompetent psychotic patients have poor insight, but non-psychotic patients with adequate insight were incompetent in a substantial number of cases. In sum: non-psychotic patients with adequate insight can be incompetent. © 2011 John Wiley & Sons A/S.

  8. Prenatal consultation: perspectives on training, relevance, and utilization among pediatric subspecialty program directors.

    PubMed

    Danziger, Phoebe; Laventhal, Naomi

    2018-05-08

    To characterize the experience and training of house officers in prenatal consultation, and to assess program directors' perceptions regarding adequacy of training, and relevance and utilization of prenatal consultation in their field. An online survey was distributed to program directors of all ACGME-accredited programs in the United States in relevant pediatric subspecialties. Ninety-five percent (142/150) of respondents agreed that prenatal consultation from their field can impact decision-making, yet 46% (69/149) believe their prenatal consult services are underutilized. The majority (56%, 86/152) reported no formal curriculum related to prenatal consultation in their program. Nine percent (14/150) rated their trainees as not adequately trained to perform competent prenatal consultation upon graduation; 35% (52/150) rated trainees as only "somewhat" competent. Our study, the first of its kind, reveals widespread lack of formal training curricula, which may explain the finding that many graduating trainees are perceived as inadequately prepared to perform competent prenatal consultation.

  9. State Competencies for Writing: Grades K-6. Technical Note.

    ERIC Educational Resources Information Center

    Lawlor, Joseph

    This paper contains descriptions of mandated minimum competency documents from seven states: Florida, Georgia, Louisiana, Michigan, Oklahoma, Tennessee, and Texas. Each description provides a picture of the general nature of the state requirements and a discussion of the specific writing skills requirements. The procedures used to compile a…

  10. Student Material for Competency-Based Education Curriculum for Welding.

    ERIC Educational Resources Information Center

    Associated Educational Consultants, Inc., Pittsburgh, PA.

    This student welding competency-based education curriculum consists of six units dealing with general areas related to trade occupations and nine units covering specific aspects of working with welding equipment and performing welding operations. Topics covered in the first six units are welding opportunities, human relations, safety, basic…

  11. Communication competencies of oncology nurses in Malaysia.

    PubMed

    Maskor, Nor Aida; Krauss, Steven Eric; Muhamad, Mazanah; Nik Mahmood, Nik Hasnaa

    2013-01-01

    This paper reports on part of a large study to identify competencies of oncology nurses in Malaysia. It focuses on oncology nurses' communications-related competency. As an important cancer care team member, oncology nurses need to communicate effectively with cancer patients. Literature shows that poor communication can make patients feel anxious, uncertain and generally not satisfied with their nurses' care. This paper deliberates on the importance of effective communication by oncology nurses in the context of a public hospital. Four focus group discussions were used in this study with 17 oncology/cancer care nurses from Malaysian public hospitals. The main inclusion criterion was that the nurses had to have undergone a post-basic course in oncology, or have work experience as a cancer care nurse. The findings indicated that nurses do communicate with their patients, patients' families and doctors to provide information about the disease, cancer treatment, disease recurrence and side effects. Nurses should have good communication skills in order to build relationships as well as to provide quality services to their patients. The paper concludes by recommending how oncology nursing competencies can be improved.

  12. Getting to Grips with On-the-Job Competencies.

    ERIC Educational Resources Information Center

    Foyster, John

    This booklet is one in a series that has been written for the general reader who wants to understand important trends in vocational education and training in Australia. Its focus is competency-based training and assessment. The booklet starts with the specific working environment of a blackjack dealer in a casino and explores the meaning of…

  13. Bilingual Competence and Bilingual Proficiency in Child Development

    ERIC Educational Resources Information Center

    Francis, Norbert

    2011-01-01

    When two or more languages are part of a child's world, we are presented with a rich opportunity to learn something about language in general and about how the mind works. In this book, Norbert Francis examines the development of bilingual proficiency and the different kinds of competence that come together in making up its component parts. In…

  14. A novel, web-based application for assessing and enhancing practice-based learning in surgery residency.

    PubMed

    Wu, Bob J; Dietz, Patrick A; Bordley, James; Borgstrom, David C

    2009-01-01

    Practice-Based Learning and Improvement (PBLI) is 1 of 6 integral competencies required by the Accreditation Council for Graduate Medical Education (ACGME) for proof of adequate resident training and accreditation of residency programs. Moreover, the Outcome Project of the ACGME is beginning to enforce the provision of documented, objective evidence of resident PBLI. Current assessment tools, such as resident portfolios and performance evaluations, by faculty tend to be qualitative in nature. However, few objective, outcome-based, and quantitative evaluation tools have been developed. A web-based application was designed to assess every consultation performed by senior residents at a university-affiliated general surgery residency. In real time, residents documented patient presentations along with their initial impression and plan. As patient outcomes became available, they were also documented into this application, which allowed residents to self-assess whether their impressions and plans were correct. A running "batting average" (BA) is then calculated based on percentage correct. Seven senior residents participated in this study, which included a total of 459 consults: 222 documented by PGY4 residents and 237 documented by PGY5 residents. The average BA of PGY4 residents in their first 3 months was 82.9%, which was followed by 85.9%, 88.7%, and 94.3% for each of the next 3 quarters. For PGY5 residents, the corresponding results were 96.4%, 94.4%, 93.8%, and 96.4% respectively. A web-based outcome-tracking program is useful for conducting rapid and ongoing evaluation of residents' practice-based learning, generating data for analysis of individual resident knowledge gaps, stimulating self-assessment and targeted learning, as well as providing objective data of PBLI for accreditation purposes.

  15. On the importance of considering heterogeneity in witnesses' competence levels when reconstructing crimes from multiple witness testimonies.

    PubMed

    Waubert de Puiseau, Berenike; Greving, Sven; Aßfalg, André; Musch, Jochen

    2017-09-01

    Aggregating information across multiple testimonies may improve crime reconstructions. However, different aggregation methods are available, and research on which method is best suited for aggregating multiple observations is lacking. Furthermore, little is known about how variance in the accuracy of individual testimonies impacts the performance of competing aggregation procedures. We investigated the superiority of aggregation-based crime reconstructions involving multiple individual testimonies and whether this superiority varied as a function of the number of witnesses and the degree of heterogeneity in witnesses' ability to accurately report their observations. Moreover, we examined whether heterogeneity in competence levels differentially affected the relative accuracy of two aggregation procedures: a simple majority rule, which ignores individual differences, and the more complex general Condorcet model (Romney et al., Am Anthropol 88(2):313-338, 1986; Batchelder and Romney, Psychometrika 53(1):71-92, 1988), which takes into account differences in competence between individuals. 121 participants viewed a simulated crime and subsequently answered 128 true/false questions about the crime. We experimentally generated groups of witnesses with homogeneous or heterogeneous competences. Both the majority rule and the general Condorcet model provided more accurate reconstructions of the observed crime than individual testimonies. The superiority of aggregated crime reconstructions involving multiple individual testimonies increased with an increasing number of witnesses. Crime reconstructions were most accurate when competences were heterogeneous and aggregation was based on the general Condorcet model. We argue that a formal aggregation should be considered more often when eyewitness testimonies have to be assessed and that the general Condorcet model provides a good framework for such aggregations.

  16. Metaphorical Competence: A Neglected Component of Communicative Competence

    ERIC Educational Resources Information Center

    Sabet, Masoud Khalili; Tavakoli, Marjaneh

    2016-01-01

    The ability to comprehend and use metaphors in L2 which is referred to as metaphorical competence is an important issue in second language acquisition. Metaphors are so pervasive in our life that we might not realize their presence and simply neglect them even in our first language. Different models of communicative competence have been suggested…

  17. Competence formation and post-graduate education in the public water sector in Indonesia

    NASA Astrophysics Data System (ADS)

    Kaspersma, J. M.; Alaerts, G. J.; Slinger, J. H.

    2012-01-01

    A framework is introduced, describing three aggregate competences for technical issues, management and governance, and a meta-competence for continuous learning and innovation, for the water sector. The four competences are further organised in a T-shaped competence profile. The framework and an assessment methodology were tested in a case study on post-graduate water education for professional staff in the Directorate General Water Resources (DGWR) in Indonesia. Though DGWR professionals have a firmly "technical" orientation, both the surveys and interviews show strong interest in the other competences: in particular the learning meta-competence, as well as the aggregate competence for management. The aggregate competence for governance systematically scores lower. A discrepancy appears to exist between the competences that staff perceive as needed in daily work, and those that could be acquired during post-graduate water education. In both locally-based and international post-graduate water education, the aggregate competences for management as well as governance are reportedly addressed modestly, if at all. With only little competence in these disciplines, it will be difficult for professionals to communicate and collaborate effectively in an interdisciplinary way. As a result, the horizontal bar of the T-shaped profile remains weakly developed. In international post-graduate education, this seems partly compensated by the attention for continuous learning and innovation. The exposure to a different culture and learning format is reported as fundamentally formative. The policies of DGWR have gone through three distinct phases. In the first phase (1970-1987) technical competence and learning were valued highly and training was arranged effectively; in the current phase the need to develop new competences is raising new challenges.

  18. Competence feedback improves CBT competence in trainee therapists: A randomized controlled pilot study.

    PubMed

    Weck, Florian; Kaufmann, Yvonne M; Höfling, Volkmar

    2017-07-01

    The development and improvement of therapeutic competencies are central aims in psychotherapy training; however, little is known about which training interventions are suitable for the improvement of competencies. In the current pilot study, the efficacy of feedback regarding therapeutic competencies was investigated in cognitive behavioural therapy (CBT). Totally 19 trainee therapists and 19 patients were allocated randomly to a competence feedback group (CFG) or control group (CG). Two experienced clinicians and feedback providers who were blind to the treatment conditions independently evaluated therapeutic competencies on the Cognitive Therapy Scale at five treatment times (i.e., at Sessions 1, 5, 9, 13, and 17). Whereas CFG and CG included regular supervision, only therapists in the CFG additionally received written qualitative and quantitative feedback regarding their demonstrated competencies in conducting CBT during treatment. We found a significant Time × Group interaction effect (η² = .09), which indicates a larger competence increase in the CFG in comparison to the CG. Competence feedback was demonstrated to be suitable for the improvement of therapeutic competencies in CBT. These findings may have important implications for psychotherapy training, clinical practice, and psychotherapy research. However, further research is necessary to ensure the replicability and generalizability of the findings.

  19. Basic numerical competences in large-scale assessment data: Structure and long-term relevance.

    PubMed

    Hirsch, Stefa; Lambert, Katharina; Coppens, Karien; Moeller, Korbinian

    2018-03-01

    Basic numerical competences are seen as building blocks for later numerical and mathematical achievement. The current study aimed at investigating the structure of early numeracy reflected by different basic numerical competences in kindergarten and its predictive value for mathematical achievement 6 years later using data from large-scale assessment. This allowed analyses based on considerably large sample sizes (N > 1700). A confirmatory factor analysis indicated that a model differentiating five basic numerical competences at the end of kindergarten fitted the data better than a one-factor model of early numeracy representing a comprehensive number sense. In addition, these basic numerical competences were observed to reliably predict performance in a curricular mathematics test in Grade 6 even after controlling for influences of general cognitive ability. Thus, our results indicated a differentiated view on early numeracy considering basic numerical competences in kindergarten reflected in large-scale assessment data. Consideration of different basic numerical competences allows for evaluating their specific predictive value for later mathematical achievement but also mathematical learning difficulties. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. 32 CFR 776.20 - Competence.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Competence. 776.20 Section 776.20 National... Professional Conduct § 776.20 Competence. (a) Competence. A covered attorney shall provide competent, diligent.... Initial determinations as to competence of a covered USG attorney for a particular assignment shall be...

  1. The effects of distress and the dimensions of coping strategies on physicians’ satisfaction with competence

    PubMed Central

    Lepnurm, Rein; Nesdole, Robert; Dobson, Roy Thomas; Peña-Sánchez, Juan-Nicolás

    2016-01-01

    Objectives: The purposes of this study were to (1) articulate the dimensions of Coping strategies used by physicians, and (2) determine whether Coping strategies alleviated Distress and enhanced Satisfaction with Competence. Methods: Comprehensive questionnaires on factors associated with Satisfaction with Competence were sent to a stratified sample of 5300 physicians across Canada. The response rate was 57% with negligible bias. Factor analysis was used to articulate the dimensions of Coping strategies. The classic Baron and Kenny regression series was used to establish whether Coping mediates the effects of Distress on Satisfaction with Competence. Years in Practice, Self-Reported Health, and Duties of Physicians were control factors. Results: A reliable 15-item measure of Coping was confirmed (α = .76) with four reasonably reliable dimensions: Collegiality (α = .80), Attitude (α = .63), Managing Work (α = .60), and Self-Care (α = .62). Physicians reported a mean Satisfaction with Competence of (M = 4.26 out of 6.0, standard deviation (SD) = 0.64) with General practitioners reporting slightly lower levels of Satisfaction with Competence than average. Conversely, chronic disease, clinical, and procedural specialists reported higher levels of Satisfaction with Competence. The mean Distress level for all physicians was (M = 3.66 out of 7.0, SD = 0.93). The highest levels of distress were reported by emergency physicians, general practitioners, and surgeons. Clinical specialists, anesthesiologists, and psychiatrists reported the lowest levels of distress. Physicians reported (M = 4.48 out of 7.0, SD = 0.78) as the mean level of Coping ability with clinical specialists and general practitioners reporting lower than average abilities to cope. Laboratory and chronic care specialists reported greater than average coping abilities. Regression analyses established Coping as a mediator of Distress which predicted physicians

  2. Neoliberalism and the government of nursing through competency-based education.

    PubMed

    Foth, Thomas; Holmes, Dave

    2017-04-01

    Competency has become a key concept in education in general over the last four decades. This article examines the development of the competency-based movement with a particular focus on the significance it has had for nursing education. Our hypothesis is that the competency movement can only adequately be understood if it is analyzed in relation to the broad societal transformation of the last decades-often summarized under the catchword neoliberalism-and with it the emergence of managerial models for Human Resource Management (HRM) for the reorganization of social services. Classical professions, which were characterized under welfarism by an esoteric knowledge based on ethical norms, have now become marketable commodities that can be evaluated in the same way as other commodities. We want to underline that while this development is still under way, it is the concept of competency that was the decisive political instrument enabling this profound change. With the widespread implementation of competency-based education that now governs nursing knowledge, the development of a critical, oppositional perspective becomes more challenging, if not entirely impossible. We will be focusing primarily on nursing education in Canada, although we maintain that it has relevance for nursing internationally. © 2016 John Wiley & Sons Ltd.

  3. Executive Functions Contribute Uniquely to Reading Competence in Minority Youth

    ERIC Educational Resources Information Center

    Jacobson, Lisa A.; Koriakin, Taylor; Lipkin, Paul; Boada, Richard; Frijters, Jan C.; Lovett, Maureen W.; Hill, Dina; Willcutt, Erik; Gottwald, Stephanie; Wolf, Maryanne; Bosson-Heenan, Joan; Gruen, Jeffrey R.; Mahone, E. Mark

    2017-01-01

    Competent reading requires various skills beyond those for basic word reading (i.e., core language skills, rapid naming, phonological processing). Contributing "higher-level" or domain-general processes include information processing speed and executive functions (working memory, strategic problem solving, attentional switching).…

  4. Regents Examinations and Competency Tests: School Administrator's Manual. 1981 Edition.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Bureau of Elementary and Secondary Educational Testing.

    Intended for use by school administrators, guidance counselors, teachers, and proctors, this manual contains general information on Regents examinations and competency tests. Specifically, the regulations and procedures for ordering, administering, and rating these examinations are described. Information is also included about the competency…

  5. Structural language, pragmatic communication, behavior, and social competence in children adopted internationally: A pilot study.

    PubMed

    Petranovich, Christine L; Walz, Nicolay Chertkoff; Staat, Mary Allen; Chiu, Chung-Yiu Peter; Wade, Shari L

    2017-01-01

    The objectives of this study were to examine the association of structural language and pragmatic communication with behavior problems and social competence in girls adopted internationally. Participants included girls between 6-12 years of age who were internationally adopted from China (n = 32) and Eastern-Europe (n = 25) and a control group of never-adopted girls (n = 25). Children completed the Wechsler Abbreviated Scale of Intelligence. Parents completed the Child Communication Checklist- second edition, the Child Behavior Checklist, and the Home and Community Social Behavior Scales. Compared to the controls, parents in the Eastern European group reported more problems with social competence, externalizing behaviors, structural language, and pragmatic communication. The Chinese group evidenced more internalizing problems. Using generalized linear regression, interaction terms were examined to determine if the associations of pragmatic communication and structural language with behavior problems and social competence varied across groups. Controlling for general intellectual functioning, poorer pragmatic communication was associated with more externalizing problems and poorer social competence. In the Chinese group, poorer pragmatic communication was associated with more internalizing problems. Post-adoption weaknesses in pragmatic communication are associated with behavior problems and social competence. Internationally adopted children may benefit from interventions that target pragmatic communication.

  6. Implementation of a competency assessment tool for agency nurses working in an acute paediatric setting.

    PubMed

    Hennerby, Cathy; Joyce, Pauline

    2011-03-01

    This paper reports on the implementation of a competency assessment tool for registered general agency nurses working in an acute paediatric setting, using a change management framework. The increased number of registered general agency nurses working in an acute children's hospital alerted concerns around their competency in working with children. These concerns were initially raised via informal complaints about 'near misses', parental dissatisfaction, perceived competency weaknesses and rising cost associated with their use. [Young's (2009) Journal of Organisational Change, 22, 524-548] nine-stage change framework was used to guide the implementation of the competency assessment tool within a paediatric acute care setting. The ongoing success of the initiative, from a nurse manager's perspective, relies on structured communication with the agency provider before employing competent agency nurses. Sustainability of the change will depend on nurse managers' persistence in attending the concerns of those resisting the change while simultaneously supporting those championing the change. These key communication and supporting roles highlight the pivotal role held by nurse managers, as gate keepers, in safe-guarding children while in hospital. Leadership qualities of nurse managers will also be challenged in continuing to manage and drive the change where resistance might prevail. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

  7. Trends in performance on the psychiatry resident-in-training examination (PRITE®): 10 years of data from a single institution.

    PubMed

    Cooke, Brian K; Garvan, Cynthia; Hobbs, Jacqueline A

    2013-07-01

    The purpose of this study was to examine trends in the Psychiatry Resident-In-Training Examination (PRITE®) scores at one institution from 2001 to 2010. The authors hypothesized that two factors, the 2003 implementation of the Accreditation Council for Graduate Medical Education (ACGME) duty-hour restrictions and the residency program's 2008 restructuring of its curriculum to a half-day per week of didactics, would lead to improved scores. Residents in the general psychiatry program at the University of Florida College of Medicine from 2001 to 2010 were included in this study. To examine the effect of the 2003 ACGME duty-hours change, the authors compared test results from 2001-2002 and 2003-2010. To examine the effect of the 2008 didactic restructuring, they compared test results from 2001-2007 and 2008-2010. There were 288 PRITE test scores from 2001 to 2010. The authors did not find a statistical difference between test results before and after the 2003 implementation of ACGME duty-hour restrictions or between test results before and after the 2008 restructuring of residency didactics. The hypothesis was rejected. The results of the literature review propose that examination scores are affected by other elements of residency training.

  8. Learning through Business Games: Acquiring Competences within Virtual Realities

    ERIC Educational Resources Information Center

    Fortmuller, Richard

    2009-01-01

    The didactic function of business games is often seen only in the development of sociocommunicative competences and general problem-solving strategies. An equally important aspect of business games lies in the acquirement of technical and problem-oriented knowledge, which is the focus of this article. Moreover, this knowledge dimension is further…

  9. Measurement of Workforce Readiness Competencies: Design of Prototype Measures.

    ERIC Educational Resources Information Center

    O'Neil, Harold F., Jr.; And Others

    A general methodology approach is suggested for measurement of workforce readiness competencies in the context of overall work by the National Center for Research on Evaluation, Standards, and Student Testing on the domain-independent measurement of workforce readiness skills. The methodology consists of 14 steps, from the initial selection of a…

  10. Academically Gifted Students' Perceived Interpersonal Competence and Peer Relationships

    ERIC Educational Resources Information Center

    Lee, Seon-Young; Olszewski-Kubilius, Paula; Thomson, Dana Turner

    2012-01-01

    Perceptions of the interpersonal competence and peer relationships of 1,526 gifted adolescents who had previously participated in academic gifted programs at the Center for Talent Development were examined, using an online survey. Major findings included that the gifted students had generally positive perceptions of their abilities to initiate,…

  11. Interaction with a high-versus low-competence influence source in inductive reasoning.

    PubMed

    Butera, Fabrizio; Caverni, Jean-Paul; Rossi, Sandrine

    2005-04-01

    Literature on inductive reasoning shows that when testing hypotheses, people are biased toward the use of confirmatory strategies (P. C. Wason, 1960). In the present article, the authors presented 2 studies showing how people use confirmation and disconfirmation strategies during actual interaction in problem solving. Study 1 showed that participants were able to learn to use disconfirmation when confronted with a low-competence, nonthreatening partner. When the partner was high in competence (thereby threatening the participant's competence), participants used confirmation, even when the partner used disconfirmation. In Study 2, the authors aimed at generalizing the aforementioned results by exploring the hypothesis that disconfirmation stems from the possibility of diverging from norms. Participants who were confronted with the violation of a conversational norm used a high proportion of disconfirmation, whatever the source of influence. When there was no violation but there was a low-competence partner, the proportion of disconfirmation was high; when there was no violation but there was a high-competence partner, the proportion of disconfirmation was low. The authors discussed the interpersonal functions of confirmation and disconfirmation.

  12. Nursing accounting competencies related to HIV in a Papua New Guinea context.

    PubMed

    Brown, Alistair M

    2013-01-01

    Nursing administration is an important part of the campaign to eliminate HIV across Papua New Guinea (PNG). This paper considers the critical importance of developing nursing leadership in effective accounting competencies in relation to HIV projects in PNG. The results of the study's textual analysis of audit reports of the Auditor General of PNG revealed a failure on the part of PNG's main health agencies involved with its national HIV program to provide competent financial reporting. In light of these results, this study shows how improving accounting and other financial competencies among nursing leaders would benefit the implementation of the PNG HIV national strategy. The findings of this study have implications not only for the internal control of HIV nursing competencies but also for nursing leadership related to HIV issues in a developing-country context. Copyright © 2013 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  13. Strategies for developing competency models.

    PubMed

    Marrelli, Anne F; Tondora, Janis; Hoge, Michael A

    2005-01-01

    There is an emerging trend within healthcare to introduce competency-based approaches in the training, assessment, and development of the workforce. The trend is evident in various disciplines and specialty areas within the field of behavioral health. This article is designed to inform those efforts by presenting a step-by-step process for developing a competency model. An introductory overview of competencies, competency models, and the legal implications of competency development is followed by a description of the seven steps involved in creating a competency model for a specific function, role, or position. This modeling process is drawn from advanced work on competencies in business and industry.

  14. Stochastic resonance and noise delayed extinction in a model of two competing species

    NASA Astrophysics Data System (ADS)

    Valenti, D.; Fiasconaro, A.; Spagnolo, B.

    2004-01-01

    We study the role of the noise in the dynamics of two competing species. We consider generalized Lotka-Volterra equations in the presence of a multiplicative noise, which models the interaction between the species and the environment. The interaction parameter between the species is a random process which obeys a stochastic differential equation with a generalized bistable potential in the presence of a periodic driving term, which accounts for the environment temperature variation. We find noise-induced periodic oscillations of the species concentrations and stochastic resonance phenomenon. We find also a nonmonotonic behavior of the mean extinction time of one of the two competing species as a function of the additive noise intensity.

  15. Industrial Arts Instructional Tasks/Competencies for Energy and Power. Competency-Based Education.

    ERIC Educational Resources Information Center

    George Mason Univ., Fairfax, VA.

    This instructional task/competency package is designed to help teachers and administrators in developing competency-based instructional materials for an energy and power course. Part 1 contains a description of the industrial arts program and a course description, instructional task/competency list, and content outline for energy and power. The…

  16. Competencies required for occupational health nurses

    PubMed Central

    Kono, Keiko; Goto, Yuki; Hatanaka, Junko; Yoshikawa, Etsuko

    2017-01-01

    Objectives: For occupational health (OH) nurses to perform activities effectively, not only skills and knowledge but also competencies proposed by Dr. McClelland are indispensable. This study aimed to identify competencies required for OH nurses and to show their structure diagram. Methods: Qualitative descriptive research was conducted from October 2010 to August 2011. Eight high-performing OH nurses participated, and data were collected from semi-structured interviews held for each nurse. Data were qualitatively and inductively analyzed using the KJ method. Results: Seven competencies were identified: "self-growth competency," "OH nursing essence perpetuation competency," "strategic planning and duty fulfillment competency," "coordination competency," "client growth support competency," "team empowerment competency," and "creative competency." A structure diagram of the seven competencies was clarified. As the definitions of the competencies were different, the findings of competencies for OH nursing in the United States of America (USA) could not simply be compared with the findings of our study; however, all seven competencies were compatible with those in AAOHN model 1 and AAOHN model 2 in the USA. Conclusion: Our seven competencies are essential for OH nurses to perform activities that meet the expectations of employees and the employer. PMID:28993570

  17. The effect of the Accreditation Council for Graduate Medical Education Duty Hours Policy on plastic surgery resident education and patient care: an outcomes study.

    PubMed

    Basu, Chandrasekhar Bob; Chen, Li-Mei; Hollier, Larry H; Shenaq, Saleh M

    2004-12-01

    The Accreditation Council for Graduate Medical Education (ACGME) Work-Hours Duty Policy became effective on July 1, 2003, mandating the reduction of resident duty work hours. The Baylor College of Medicine Multi-Institutional Integrated Plastic Surgery Program instituted a resident duty work-hours policy on July 1, 2002 (1 year ahead of the national mandate). Outcomes data are needed to facilitate continuous improvements in plastic surgical residency training while maintaining high-quality patient care. To assess the effect of this policy intervention on plastic surgery resident education as measured through the six core competencies and patient/resident safety, the investigators surveyed all categorical plastic surgery residents 6 months after implementation of the policy. This work represents the first empiric study investigating the effect of duty hours reduction on plastic surgery training and education. The categorical plastic surgery residents at the Baylor College of Medicine Multi-Institutional Integrated Plastic Surgery Program completed a 68-item survey on a five-point Likert scale (1 = strongly disagree to 5 = strongly agree). Residents were asked to rate multiple parameters based on the ACGME six core competencies, including statements on patient care and clinical/operative duties, resident education, resident quality of life, and resident perceptions on this policy. All surveys were completed anonymously. The sample size was n = 12 (program year 3 through program year 6), with a 100 percent response rate. Univariate and bivariate statistical analysis was conducted with SPSS version 10.0 statistical software. Specifically, interquartile deviations were used to find consensus among resident responses to each statement. Descriptive statistics indicated higher percentages of agreement on a majority of statements in three categories, including patient care and clinical/operative duties, academic duties, and resident quality of life. Using interquartile

  18. Intercultural Competency at the Geographic Combatant Command Level

    DTIC Science & Technology

    2011-05-04

    side. Individualistic cultures value self-reliance and initiative. Competition is generally accepted and expected. Collectivistic cultures tend to...investors. A significant historic example of collectivistic culture is the Japanese. During World War II, their emphasis was on the empire. This...to incorporate available intercultural competency assets at the GCC level to leverage existing cultural expertise: Foreign Area Officers (FAOs), DoD

  19. Giving Context to the Physician Competency Reference Set: Adapting to the Needs of Diverse Populations

    PubMed Central

    Eckstrand, Kristen L.; Potter, Jennifer; Bayer, Carey Roth; Englander, Robert

    2016-01-01

    Delineating the requisite competencies of a 21st-century physician is the first step in the paradigm shift to competency-based medical education. Over the past two decades, more than 150 lists of competencies have emerged. In a synthesis of these lists, the Physician Competency Reference Set (PCRS) provided a unifying framework of competencies that define the general physician. The PCRS is not context or population specific; however, competently caring for certain underrepresented populations or specific medical conditions can require more specific context. Previously developed competency lists describing care for these populations have been disconnected from an overarching competency framework, limiting their uptake. To address this gap, the Association of American Medical Colleges Advisory Committee on Sexual Orientation, Gender Identity, and Sex Development adapted the PCRS by adding context- and content-specific qualifying statements to existing PCRS competencies to better meet the needs of diverse patient populations. This Article describes the committee’s process in developing these qualifiers of competence. To facilitate widespread adoption of the contextualized competencies in U.S. medical schools, the committee used an established competency framework to develop qualifiers of competence to improve the health of individuals who are lesbian, gay, bisexual, transgender; gender nonconforming; or born with differences in sexual development. This process can be applied to other underrepresented populations or medical conditions, ensuring that relevant topics are included in medical education and, ultimately, health care outcomes are improved for all patients inclusive of diversity, background, and ability. PMID:26796092

  20. The value of internship in graduate medical education: survey of emergency medicine residents and program directors.

    PubMed

    Ray, Adam M

    2007-01-01

    To assess the opinions of emergency medicine (EM) residents and program directors about the value of completing a nonrequired 1-year internship before entering an EM residency program accredited by the Accreditation Council for Graduate Medical Education (ACGME). An eight-question, self-administered online survey was e-mailed to EM residents who had completed a nonrequired internship before entering ACGME-accredited residency programs. A separate, six-question survey was e-mailed to program directors of ACGME-accredited programs that do not require an internship who had ever had a resident who had completed a nonrequired internship. Forty-six (27 [59%] osteopathic, 19 [41%] allopathic) of 113 residents and 40 of 124 program directors responded to the survey questions. Less than 4% of residents completed a separate nonrequired 1-year internship. The most common reason for completing a nonrequired internship was to obtain licensure by the American Osteopathic Association (19 [41%]). Most residents believed that they were more proficient with history-taking and physical examinations (38 [83%]) and procedures (34 [74%]) during the first year of residency than their colleagues who did not complete an internship, but this percentage decreased over time. The program directors had similar opinions. Most osteopathic residents who completed the internship for osteopathic licensure would not have done so if it were not required. Most (39 of 40) program directors would not recommend taking a nonrequired internship. Completing a 1-year internship before entering an EM residency program may better prepare physicians for their first year of residency in terms of basic clinical competancy, but further study is needed in this area.

  1. Social Empowerment in Mexican Violent Contexts through Media Competence

    ERIC Educational Resources Information Center

    Grijalva-Verdugo, Abel-Antonio; Moreno-Candil, David

    2017-01-01

    The acquisition of digital skills, media diet management, and general knowledge of ICT, is essential for the development and empowerment of audiences in the current media ecology, particularly considering the political and social challenges of the Latin American environment. In that sense, the study of media competence is urgent for sizing up the…

  2. A national review of the frequency of minimally invasive surgery among general surgery residents: assessment of ACGME case logs during 2 decades of general surgery resident training.

    PubMed

    Richards, Morgan K; McAteer, Jarod P; Drake, F Thurston; Goldin, Adam B; Khandelwal, Saurabh; Gow, Kenneth W

    2015-02-01

    Minimally invasive surgery (MIS) has created a shift in how many surgical diseases are treated. Examining the effect on resident operative experience provides valuable insight into trends that may be useful for restructuring the requirements of resident training. To evaluate changes in general surgery resident operative experience regarding MIS. Retrospective review of the frequency of MIS relative to open operations among general surgery residents using the Accreditation Council for Graduate Medical Education case logs for academic years 1993-1994 through 2011-2012. General surgery residency training among accredited programs in the United States. We analyzed the difference in the mean number of MIS techniques and corresponding open procedures across training periods using 2-tailed t tests with statistical significance set at P < .05. Of 6,467,708 operations with the option of MIS, 2,393,030 (37.0%) were performed with the MIS approach. Of all MIS operations performed, the 5 most common were cholecystectomy (48.5%), appendectomy (16.2%), groin hernia repair (10.0%), abdominal exploration (nontrauma) (4.4%), and antireflux procedures (3.6%). During the study period, there was a transition from a predominantly open to MIS approach for appendectomy, antireflux procedures, thoracic wedge resection, and partial gastric resection. Cholecystectomy is the only procedure for which MIS was more common than the open technique throughout the study period (P < .001). The open approach is more common for all other procedures, including splenectomy (0.7% MIS), common bile duct exploration (24.9% MIS), gastrostomy (25.9% MIS), abdominal exploration (33.1% MIS), hernia (20.3% MIS), lung resection (22.3% MIS), partial or total colectomy (39.1%), enterolysis (19.0% MIS), ileostomy (9.0% MIS), enterectomy (5.2% MIS), vagotomy (1.8% MIS), and pediatric antireflux procedures (35.9% MIS); P < .001. Minimally invasive surgery has an increasingly prominent role in contemporary

  3. General surgery residency program websites: usefulness and usability for resident applicants.

    PubMed

    Reilly, Eugene F; Leibrandt, Thomas J; Zonno, Alan J; Simpson, Mary Christina; Morris, Jon B

    2004-01-01

    To assess the content of general surgery residency program websites, the websites' potential as tools in resident recruitment, and their "usability." The homepages of general surgery residency programs were evaluated for accessibility, ease-of-use, adherence to established principles of website design, and content. Investigators completed a questionnaire on aspects of their online search, including number of mouse-clicks used, number of errors encountered, and number of returns to the residency homepage. The World Wide Web listings on the Fellowship and Residency Electronic Interactive Database (FREIDA) of the American Medical Association (AMA). A total of 251 ACGME-accredited general surgery residency programs. One hundred sixty-seven programs (67%) provided a viable link to the program's website. Evaluators found an average of 5.9 of 16 content items; 2 (1.2%) websites provided as many as 12 content items. Five of the 16 content items (program description, conference schedules, listing of faculty, caseload, and salary) were found on more than half of the sites. An average of 24 mouse-clicks was required to complete the questionnaire for each site. Forty-six sites (28%) generated at least 1 error during our search. The residency homepage was revisited an average of 5 times during each search. On average, programs adhered to 6 of the 10 design principles; only 6 (3.6%) sites adhered to all 10 design principles. Two of the 10 design principles (use of familiar fonts, absence of frames) were adhered to in more than half of the sites. Our overall success rate when searching residency websites was 38%. General surgery residency programs do not use the World Wide Web optimally, particularly for users who are potential residency candidates. The usability of these websites could be increased by providing relevant content, making that content easier to find, and adhering to established web design principles.

  4. International Space Station Human Behavior and Performance Competency Model: Volume I

    NASA Technical Reports Server (NTRS)

    Schmidt, Lacey

    2008-01-01

    This document defines Human Behavior and Performance (HBP) competencies that are recommended to be included as requirements to participate in international long duration missions. They were developed in response to the Multilateral Crew Operations Panel (MMOP) request to develop HBP training requirements for the International Space Station (ISS). The competency model presented here was developed by the ITCB HBPT WG and forms the basis for determining the HBP training curriculum for long duration crewmembers. This document lists specific HBP competencies and behaviors required of astronauts/cosmonauts who participate in ISS expedition and other international longduration missions. Please note that this model does not encompass all competencies required. For example, outside the scope of this document are cognitive skills and abilities, including but not limited to concentration, memorization, perception, imagination, and thinking. It is assumed that these skills, which are crucial in terms of human behavior and performance, are considered during selection phase since such professionally significant qualities of the operator should be taken into consideration in order to ensure sufficient baseline levels that can be further improved during general astronaut training. Also, technical competencies, even though critical for crewmembers, are beyond the scope of this document. It should also be noted that the competencies in this model (and subsequent objectives) are not intended to limit the internal activities or training programs of any international partner.

  5. Medical students' clerkship experiences and self-perceived competence in clinical skills.

    PubMed

    Katowa-Mukwato, P; Andrews, B; Maimbolwa, M; Lakhi, S; Michelo, C; Mulla, Y; Banda, S S

    2014-01-01

    In a traditional curriculum, medical students are expected to acquire clinical competence through the apprenticeship model using the Halstedian "see one, do one, and teach one, approach". The University of Zambia School of Medicine used a traditional curriculum model from 1966 until 2011 when a competence-based curriculum was implemented. To explore medical students' clerkships experiences and self-perceived competence in clinical skills. A cross-sectional survey was conducted on 5th, 6 th , and 7 th year medical students of the University of Zambia, School of Medicine two months prior to final examinations. Students were asked to rate their clerkship experiences with respect to specific skills on a scale of 1 to 4 and their level of self-perceived competence on a scale of 1 to 3. Skills evaluated were in four main domains: history taking and communication, physical examination, procedural, and professionalism, team work and medical decision making. Using Statistical Package for Social Scientist (SPSS), correlations were performed between experiences and self-perceived competence on specific skills, within domains and overall. Out of 197 clinical students 138 (70%) participated in the survey. The results showed significant increase in the proportion of students performing different skills and reporting feeling very competent with each additional clinical year. Overall correlations between experience and self-perceived competence were moderate (0.55). On individual skills, the highest correlation between experience and self-perceived competence were observed on mainly medical and surgical related procedural skills with the highest at 0.82 for nasal gastric tube insertion and 0.76 for endotracheal intubation. Despite the general improvement in skills experiences and self-perceived competence, some deficiencies were noted as significant numbers of final year students had never attempted common important procedures especially those performed in emergency situations

  6. Training needs for general dentistry residents to place and restore two-implant-retained mandibular overdentures.

    PubMed

    Malmstrom, Hans; Xiao, Jin; Romanos, Georgios E; Ren, Yan-Fang

    2015-01-01

    Implant therapy is rapidly becoming a standard of care for replacing missing dentition. Predoctoral dental curricula include some training in the implant restorative phase but offer limited exposure to the surgical phase, so it is important for postdoctoral general dentistry residency programs to provide competency training in all phases of implant therapy. The aim of this study was to determine the training needed for general dentistry residents to achieve competence in this area, specifically by defining the number of clinical experiences necessary in both the surgical and prosthetic phases of implant-retained mandibular overdenture construction (IRMOD). Fifteen Advanced Education in General Dentistry (AEGD) residents at one academic dental institution placed two implants in a total of 50 patients with edentulous mandibles and subsequently restored them with IRMOD. The supervising faculty member and the residents evaluated the competency level on a five-point scale after each implant placement and prosthetic case completion. According to the faculty evaluations, the residents achieved surgical competence after placing two implants in four to six cases and prosthetic management competence after restoring two to four cases of IRMOD. All 50 patients were satisfied with the treatment outcomes of IRMOD. This study concluded that general dentistry residents could potentially achieve competence in both the surgical and prosthetic phases of implant therapy while enrolled in an AEGD program.

  7. How to get the most out of your orthopaedic fellowship: thinking about practice-based learning.

    PubMed

    Templeman, David

    2012-09-01

    Practice-based learning and improvement is an important skill set to develop during an orthopaedic trauma fellowship and is 1 of the 6 core competencies stated by the ACGME. The review of clinic cases is best done using a few simple models to develop a structured approach for studying cases. Three common sense and easy-to-use strategies to improve clinical practice are as follows: performing each case three times, studying the 4 quadrants of patient outcomes, and the application of the Pareto 80/20 rule. These principles help to develop a structured approach for analyzing and thinking about practice-based experiences.

  8. Competence and Competency-based Training: What the Literature Says

    ERIC Educational Resources Information Center

    Guthrie, Hugh

    2009-01-01

    This literature review, commissioned by the National Quality Council, provides a historical account of the development of competency-based training in Australia and summarises the issues arising from the range of reviews conducted on elements of the national training system. It also explores the variety of ways in which competence is conceived…

  9. [Competencies in the education of nursing technicians to implement the nursing care systematization].

    PubMed

    da Cruz, Andrea de Mello Pereira; Almeida, Miriam de Abreu

    2010-12-01

    This is a qualitative, exploratory and descriptive study whose general objective was to learn, considering the perspective of the nursing technician who works in school hospitals, the competencies developed during their educational process to implement the Nursing Care Systematization (NCS). Data collection and analysis were carried out through a focal group, with content analysis and nursing technicians. Two thematic categories emerged: The participation of the nursing technician in the NCS and The competencies in the education of the nursing technician. Each one received two subcategories: Conception of the NCS and (De)valuation of the NCS, Technical-scientific competency and Competency in the interpersonal relationship, respectively. It was observed that the NCS must be shared, discussed and made public among nursing professionals, so that they may acknowledge themselves as the leading actors of their methodology and be aware that their practices determine the results.

  10. LGBT-Competence in Social Work Education: The Relationship of School Contexts to Student Sexual Minority Competence.

    PubMed

    McCarty-Caplan, David

    2018-01-01

    This study examined the relationship between master of social work programs' (MSW) support of lesbian, gay, bisexual, and transgender people (LGBT-competence) and the sexual minority competence (LGB-competence) of social work students. Data were gathered from a sample of MSW program directors, faculty members, and students (N = 1385) within 34 MSW programs in the United States. A series of hierarchical linear models tested if a MSW program's LGBT-competence was associated with the LGB-competence of its students. Results showed a significant relationship between organizational LGBT-competence and individual LGB-competence within schools of social work, and that programs with greater LGBT-competence also had students who felt more competent to work with sexual minorities. These findings suggest schools of social work can take substantive action at an organizational level to improve the professional LGB-competence of future social workers. Implications for social work education are discussed.

  11. Competencies in Professional Psychology

    ERIC Educational Resources Information Center

    Kaslow, Nadine J.

    2004-01-01

    There has been a burgeoning interest in competency-based education and credentialing in professional psychology. This movement gained momentum at the Competencies Conference: Future Directions in Education and Credentialing in Professional Psychology. After defining professional competence, the author focuses on the identification and delineation…

  12. Competency Guidelines for Public Health Laboratory Professionals: CDC and the Association of Public Health Laboratories.

    PubMed

    Ned-Sykes, Renée; Johnson, Catherine; Ridderhof, John C; Perlman, Eva; Pollock, Anne; DeBoy, John M

    2015-05-15

    These competency guidelines outline the knowledge, skills, and abilities necessary for public health laboratory (PHL) professionals to deliver the core services of PHLs efficiently and effectively. As part of a 2-year workforce project sponsored in 2012 by CDC and the Association of Public Health Laboratories (APHL), competencies for 15 domain areas were developed by experts representing state and local PHLs, clinical laboratories, academic institutions, laboratory professional organizations, CDC, and APHL. The competencies were developed and reviewed by approximately 170 subject matter experts with diverse backgrounds and experiences in laboratory science and public health. The guidelines comprise general, cross-cutting, and specialized domain areas and are divided into four levels of proficiency: beginner, competent, proficient, and expert. The 15 domain areas are 1) Quality Management System, 2) Ethics, 3) Management and Leadership, 4) Communication, 5) Security, 6) Emergency Management and Response, 7) Workforce Training, 8) General Laboratory Practice, 9) Safety, 10) Surveillance, 11) Informatics, 12) Microbiology, 13) Chemistry, 14) Bioinformatics, and 15) Research. These competency guidelines are targeted to scientists working in PHLs, defined as governmental public health, environmental, and agricultural laboratories that provide analytic biological and/or chemical testing and testing-related services that protect human populations against infectious diseases, foodborne and waterborne diseases, environmental hazards, treatable hereditary disorders, and natural and human-made public health emergencies. The competencies support certain PHL workforce needs such as identifying job responsibilities, assessing individual performance, and providing a guiding framework for producing education and training programs. Although these competencies were developed specifically for the PHL community, this does not preclude their broader application to other professionals

  13. Competency Mapping of the Employees

    NASA Astrophysics Data System (ADS)

    Anisha, N.

    2012-10-01

    Human resource management is a process of bringing people and organizations together so that the goals of each other are met. Nowadays it is not possible to show a good financial or operating report unless your personnel relations are in order. Over the years, highly skilled and knowledge based jobs are increasing while low skilled jobs are decreasing. Competency Mapping is a process of identifying key competencies for an organization, the jobs and functions within it. Competency mapping, the buzz word in any industry is not complicated as it may appear. At the heart of any successful activity lies a competence or skill. In the recent years, various thought leaders in business strategy have emphasized the need to identify what competencies a business needs, in order to compete in a specific environment. In this article explains the why competencies needed and how is measured competency of employees in the organization.

  14. Can Hospital Cultural Competency Reduce Disparities in Patient Experiences with Care?

    PubMed Central

    Weech-Maldonado, Robert; Elliott, Marc N.; Pradhan, Rohit; Schiller, Cameron; Hall, Allyson; Hays, Ron D.

    2013-01-01

    Background Cultural competency has been espoused as an organizational strategy to reduce health disparities in care. Objective To examine the relationship between hospital cultural competency and inpatient experiences with care. Research Design The first model predicted Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores from hospital random effects, plus fixed effects for hospital cultural competency, individual race/ethnicity/language, and case-mix variables. The second model tested if the association between a hospital’s cultural competency and HCAHPS scores differed for minority and non-Hispanic white patients. Subjects The National CAHPS® Benchmarking Database’s (NCBD) HCAHPS Surveys and the Cultural Competency Assessment Tool of Hospitals (CCATH) Surveys for California hospitals were merged, resulting in 66 hospitals and 19,583 HCAHPS respondents in 2006. Measures Dependent variables include ten HCAHPS measures: six composites (communication with doctors, communication with nurses, staff responsiveness, pain control, communication about medications, and discharge information), two individual items (cleanliness, and quietness of patient rooms), and two global items (overall hospital rating, and whether patient would recommend hospital). Results Hospitals with greater cultural competency have better HCAHPS scores for doctor communication, hospital rating, and hospital recommendation. Furthermore, HCAHPS scores for minorities were higher at hospitals with greater cultural competency on four other dimensions: nurse communication, staff responsiveness, quiet room, and pain control. Conclusions Greater hospital cultural competency may improve overall patient experiences, but may particularly benefit minorities in their interactions with nurses and hospital staff. Such effort may not only serve longstanding goals of reducing racial/ethnic disparities in inpatient experience, but may also contribute to general quality improvement

  15. Beyond JCAHO: using competency models to change healthcare organizations. Part 2: Developing competence assessment systems.

    PubMed

    Decker, P J; Strader, M K; Wise, R J

    1997-01-01

    In 1996, JCAHO required hospitals to assess, prove, track, and improve the competence of all employees. This article is the second part of a review of the concept of competency assessment and the implications of meeting and exceeding the JCAHO standards. Part 1 (in the previous issue of Hospital Topics) provided the theory of competence assessment, the current situation in JCAHO surveys, and an overview of the problems inherent in competency assessment. This part puts competence assessment in the context of quality improvement and provides the details of developing competence assessment systems.

  16. Unleashing Natural Competence in Lactococcus lactis by Induction of the Competence Regulator ComX

    PubMed Central

    Mulder, Joyce; Wels, Michiel; Kuipers, Oscar P.; Bron, Peter A.

    2017-01-01

    ABSTRACT In biotechnological workhorses like Streptococcus thermophilus and Bacillus subtilis, natural competence can be induced, which facilitates genetic manipulation of these microbes. However, in strains of the important dairy starter Lactococcus lactis, natural competence has not been established to date. However, in silico analysis of the complete genome sequences of 43 L. lactis strains revealed complete late competence gene sets in 2 L. lactis subsp. cremoris strains (KW2 and KW10) and at least 10 L. lactis subsp. lactis strains, including the model strain IL1403 and the plant-derived strain KF147. The remainder of the strains, including all dairy isolates, displayed genomic decay in one or more of the late competence genes. Nisin-controlled expression of the competence regulator comX in L. lactis subsp. lactis KF147 resulted in the induction of expression of the canonical competence regulon and elicited a state of natural competence in this strain. In contrast, comX expression in L. lactis NZ9000, which was predicted to encode an incomplete competence gene set, failed to induce natural competence. Moreover, mutagenesis of the comEA-EC operon in strain KF147 abolished the comX-driven natural competence, underlining the involvement of the competence machinery. Finally, introduction of nisin-inducible comX expression into nisRK-harboring derivatives of strains IL1403 and KW2 allowed the induction of natural competence in these strains also, expanding this phenotype to other L. lactis strains of both subspecies. IMPORTANCE Specific bacterial species are able to enter a state of natural competence in which DNA is taken up from the environment, allowing the introduction of novel traits. Strains of the species Lactococcus lactis are very important starter cultures for the fermentation of milk in the cheese production process, where these bacteria contribute to the flavor and texture of the end product. The activation of natural competence in this industrially

  17. Competing role of Interactions in Synchronization of Exciton-Polariton condensates

    NASA Astrophysics Data System (ADS)

    Khan, Saeed; Tureci, Hakan E.

    We present a theoretical study of synchronization dynamics in incoherently pumped exciton-polariton condensates in coupled traps. Our analysis is based on an expansion in non-Hermitian modes that take into account the trapping potential and the pump-induced complex-valued potential. We find that polariton-polariton and reservoir-polariton interactions play competing roles in the emergence of a synchronized phase as pumping power is increased, leading to qualitatively different synchronized phases. Crucially, these interactions can also act against each other to hinder synchronization. We present a phase diagram and explain the general characteristics of these phases using a generalized Adler equation. Our work sheds light on dynamics strongly influenced by competing interactions particular to incoherently pumped exciton-polariton condensates, which can lead to interesting features in recently engineered polariton lattices. This work was supported by the US Department of Energy, Office of Basic Energy Sciences, Division of Materials Sciences and Engineering.

  18. Dental Assisting Competencies. Final Report.

    ERIC Educational Resources Information Center

    Richards, Beverly; And Others

    This document contains dental assisting competencies and competency-based performance objectives, learning activities, resources, and evaluation procedures for each competency that was adapted and developed by instructors of dental assisting to suit the needs and legal parameters of Pennsylvania. The competencies and associated elements are…

  19. Competencies in Science Teaching

    ERIC Educational Resources Information Center

    Mathelitsch, Leopold

    2013-01-01

    The role of competencies is discussed with respect to science teaching. In particular, competence models from Germany, Switzerland and Austria are presented and compared. A special topical program, "Competencies in Mathematics and Science Teaching", was started in Austria three years ago. Initial experiences with this program are…

  20. Healthcare provider cultural competency: development and initial validation of a patient report measure.

    PubMed

    Lucas, Todd; Michalopoulou, Georgia; Falzarano, Pamela; Menon, Shanti; Cunningham, Windy

    2008-03-01

    Health researchers have proposed that provider cultural competency may contribute to health disparities. Yet, this belief continues to lack empirical support, and this is due in part to measurement issues that have plagued the cultural competency construct. In the present research, we report on the development of a theoretically grounded, generally applicable, and patient report measure of provider cultural competency. Samples of predominantly African American patients (N=310) were recruited from three urban medical clinics to complete a survey about their relationship with their physician. We examined the factor structure, validity and other psychometric characteristics of a newly proposed patient report measure of provider cultural competency. Psychometric analyses supported a tripartite model of cultural competency that was comprised of patient judgments of their physician's cultural knowledge, awareness, and skill. In addition, this result was replicated across multiple clinical contexts, while also demonstrating convergent and incremental validity when correlated with measures of trust, satisfaction and discrimination. This newly proposed measure addresses prior limitations in cultural competency measurement and may enhance future research by providing a standardized tool for use in multiple clinical and cultural contexts. Copyright (c) 2008 APA, all rights reserved.

  1. Where Cultural Competency Begins: Changes in Undergraduate Students' Intercultural Competency

    ERIC Educational Resources Information Center

    Sandell, Elizabeth J.; Tupy, Samantha J.

    2015-01-01

    Teacher preparation programs and accreditation organizations have acknowledged need for educators to demonstrate intercultural knowledge, skills, and abilities. Teacher educators are responding to emphasis in higher education to assure that graduates achieve intercultural competence (NCATE, 2008). This study compared the cultural competency of…

  2. Developing Navigation Competencies to Care for Older Rural Adults with Advanced Illness.

    PubMed

    Duggleby, Wendy; Robinson, Carole A; Kaasalainen, Sharon; Pesut, Barbara; Nekolaichuk, Cheryl; MacLeod, Roderick; Keating, Norah C; Santos Salas, Anna; Hallstrom, Lars K; Fraser, Kimberly D; Williams, Allison; Struthers-Montford, Kelly; Swindle, Jennifer

    2016-06-01

    Navigators help rural older adults with advanced illness and their families connect to needed resources, information, and people to improve their quality of life. This article describes the process used to engage experts - in rural aging, rural palliative care, and navigation - as well as rural community stakeholders to develop a conceptual definition of navigation and delineate navigation competencies for the care of this population. A discussion paper on the important considerations for navigation in this population was developed followed by a four-phased Delphi process with 30 expert panel members. Study results culminated in five general navigation competencies for health care providers caring for older rural persons and their families at end of life: provide patient/family screening; advocate for the patient/family; facilitate community connections; coordinate access to services and resources; and promote active engagement. Specific competencies were also developed. These competencies provide the foundation for research and curriculum development in navigation.

  3. Welding. Ohio's Competency Analysis Profile.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Vocational Instructional Materials Lab.

    This Ohio Competency Analysis Profile (OCAP), derived from a modified Developing a Curriculum (DACUM) process, is a comprehensive and verified employer competency list for a welding program. It contains units (with or without subunits), competencies, and competency builders that identify the occupational, academic, and employability skills needed…

  4. Carpentry. Ohio's Competency Analysis Profile.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Vocational Instructional Materials Lab.

    This comprehensive and verified employer competency list was developed from a modified DACUM (Developing a Curriculum) process involving business, industry, labor, and community agency representatives from Ohio. This competency list contains 14 units (with or without subunits), competencies, and competency builders that identify the occupational,…

  5. Medical Assisting Competencies. Final Report.

    ERIC Educational Resources Information Center

    Richards, Beverly; And Others

    This document contains medical assisting competencies and competency-based performance objectives, learning activities, resources, and levels of achievement for each competency that were adapted and developed by instructors of medical assisting to suit the needs and legal parameters of Pennsylvania. The competencies and associated elements are…

  6. Cosmetology. Ohio's Competency Analysis Profile.

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Vocational Instructional Materials Lab.

    This comprehensive and verified employer competency list was developed from a modified DACUM (Developing a Curriculum) process involving business, industry, labor, and community agency representatives from Ohio. This competency list contains 17 units (with or without subunits), competencies, and competency builders that identify the occupational,…

  7. Comparative Analysis of Ukrainian and Foreign Scholars' Views on Interpretation of Such Terms as Competency, Professional Competency, Professional Competency of Technicians in Food Technology

    ERIC Educational Resources Information Center

    Yakovchuk, Olha

    2017-01-01

    The article deals with a comparative analysis of the content of such terms as competency, competence and professional competency of technicians in food technology. Special attention has been given to domestic and foreign scholars' research findings on the matter in order to consider the genesis of the term "competency" and its spreading…

  8. Components of cognitive competence predictive of occupational competence in persons with dementia: a Delphi study.

    PubMed

    Zur, Briana M; Rudman, Debbie Laliberte; Johnson, Andrew M; Roy, Eric A; Wells, Jennie L

    2013-04-01

    Within the area of dementia care, occupational therapists are asked to predict occupational competence in everyday living and often do so by assessing cognitive competence. Considering the cognitive changes that occur with dementia over time, the construct of cognitive competence is a key consideration. Still, a gap exists in the literature examining the relationship between cognitive competence and occupational competence. This study developed a consensus among participating Canadian occupational therapists regarding the components of cognitive competence they considered essential to predict occupational competence in people with dementia. A three-round Delphi study was completed with English- and French-speaking occupational therapists (n = 127; 116; 125) experienced in dementia care. Ten cognitive components were identified as essential to predict occupational competence in individuals with dementia. The 10 identified components provide direction for assessment practices and education in dementia care and for development of measurement tools.

  9. Initial Development and Validation of the Mexican Intercultural Competence Scale

    PubMed Central

    Torres, Lucas

    2013-01-01

    The current project sought to develop the Mexican Intercultural Competence Scale (MICS), which assesses group-specific skills and attributes that facilitate effective cultural interactions, among adults of Mexican descent. Study 1 involved an Exploratory Factor Analysis (N = 184) that identified five factors including Ambition/Perseverance, Networking, the Traditional Latino Culture, Family Relationships, and Communication. In Study 2, a Confirmatory Factor Analysis provided evidence for the 5-factor model for adults of Mexican origin living in the Midwest (N = 341) region of the U.S. The general findings are discussed in terms of a competence-based formulation of cultural adaptation and include theoretical and clinical implications. PMID:24058890

  10. Initial Development and Validation of the Mexican Intercultural Competence Scale.

    PubMed

    Torres, Lucas

    2013-01-01

    The current project sought to develop the Mexican Intercultural Competence Scale (MICS), which assesses group-specific skills and attributes that facilitate effective cultural interactions, among adults of Mexican descent. Study 1 involved an Exploratory Factor Analysis ( N = 184) that identified five factors including Ambition/Perseverance, Networking, the Traditional Latino Culture, Family Relationships, and Communication. In Study 2, a Confirmatory Factor Analysis provided evidence for the 5-factor model for adults of Mexican origin living in the Midwest ( N = 341) region of the U.S. The general findings are discussed in terms of a competence-based formulation of cultural adaptation and include theoretical and clinical implications.

  11. An Organization's Extended (Soft) Competencies Model

    NASA Astrophysics Data System (ADS)

    Rosas, João; Macedo, Patrícia; Camarinha-Matos, Luis M.

    One of the steps usually undertaken in partnerships formation is the assessment of organizations’ competencies. Typically considered competencies of a functional or technical nature, which provide specific outcomes can be considered as hard competencies. Yet, the very act of collaboration has its specific requirements, for which the involved organizations must be apt to exercise other type of competencies that affect their own performance and the partnership success. These competencies are more of a behavioral nature, and can be named as soft-competencies. This research aims at addressing the effects of the soft competencies on the performance of the hard ones. An extended competencies model is thus proposed, allowing the construction of adjusted competencies profiles, in which the competency levels are adjusted dynamically according to the requirements of collaboration opportunities.

  12. Competencies: The Competencies Debate in Australian Education and Training.

    ERIC Educational Resources Information Center

    Collins, Cherry, Ed.

    Competencies are the focal concept in the world of education and training in Australia at this moment in 1993. This book is a collection of papers and has three purposes. First, it aims to provide basic information about education and training. Second, the book aims to explore something of what competency-based education and training looks like in…

  13. Competency-Based Horticulture: Floriculture.

    ERIC Educational Resources Information Center

    College of DuPage, Glen Ellyn, IL.

    This competency-based horticulture curriculum guide is designed to provide secondary and postsecondary horticulture teachers with a task-oriented program in floriculture. It contains a master resource list, a listing of floriculture resources available from various states, and 89 competency task sheets organized into nine competency areas. These…

  14. Essential competencies in global health research for medical trainees: A narrative review.

    PubMed

    White, Mary T; Satterfield, Caley A; Blackard, Jason T

    2017-09-01

    Participation in short-term educational experiences in global health (STEGHs) among medical trainees is increasingly accompanied by interest in conducting research while abroad. Because formal training in both global health and research methods is currently under-represented in most medical curricula, trainees are often unfamiliar with the knowledge, attitudes, and skills necessary to design and conduct research successfully. This narrative review identifies essential global health research competencies for medical trainees engaged in STEGHs. The authors searched the literature using the terms global health, competency, research, research methods/process/training, scholarly project, medical student, and medical education/education. Because articles directly addressing global health research competencies for medical trainees were limited, the authors additionally drew on the broader literature addressing general research competencies and global health competencies. Articles yielded by the literature search, combined with established guidelines in research ethics and global health ethics, were used to identify six core domains and twenty discrete competencies fundamental to global health research at a level appropriate for medical trainees enrolled in STEGHs. Consideration was given to diverse research modalities, varying levels of training, and the availability of mentoring and on-site support. Research may provide important benefits to medical trainees and host partners. These competencies provide a starting point; however, circumstances at any host site may necessitate additional competencies specific to that setting. These competencies are also limited by the methodology employed in their development and the need for additional perspectives from host partners. The competencies identified outline basic knowledge, attitudes, and skills necessary for medical trainees to conduct limited global health research while participating in STEGHS. They may also be used as a

  15. The need for a systematic approach to disaster psychosocial response: a suggested competency framework.

    PubMed

    Cox, Robin S; Danford, Taryn

    2014-04-01

    Competency models attempt to define what makes expert performers "experts." Successful disaster psychosocial planning and the institutionalizing of psychosocial response within emergency management require clearly-defined skill sets. This necessitates anticipating both the short- and long-term psychosocial implications of a disaster or health emergency (ie, pandemic) by developing effective and sustained working relationships among psychosocial providers, programs, and other planning partners. The following article outlines recommended competencies for psychosocial responders to enable communities and organizations to prepare for and effectively manage a disaster response. Competency-based models are founded on observable performance or behavioral indicators, attitudes, traits, or personalities related to effective performance in a specific role or job. After analyzing the literature regarding competency-based frameworks, a proposed competency framework that details 13 competency domains is suggested. Each domain describes a series of competencies and suggests behavioral indicators for each competency and, where relevant, associated training expectations. These domains have been organized under three distinct categories or types of competencies: general competency domains; disaster psychosocial intervention competency domains; and disaster psychosocial program leadership and coordination competency domains. Competencies do not replace job descriptions nor should they be confused with performance assessments. What they can do is update and revise job descriptions; orient existing and new employees to their disaster/emergency roles and responsibilities; target training needs; provide the basis for ongoing self-assessment by agencies and individuals as they evaluate their readiness to respond; and provide a job- or role-relevant basis for performance appraisal dimensions or standards and review discussions. Using a modular approach to psychosocial planning, service

  16. Assessing Competencies in a Master of Science in Clinical Research Program: The Comprehensive Competency Review.

    PubMed

    Robinson, Georgeanna F W B; Moore, Charity G; McTigue, Kathleen M; Rubio, Doris M; Kapoor, Wishwa N

    2015-12-01

    Competencies in Master of Science Clinical Research programs are becoming increasingly common. However, students and programs can only benefit fully from competency-based education if students' competence is formally assessed. Prior to a summative assessment, students must have at least one formative, formal assessment to be sure they are developing competence appropriate for their stage of training. This paper describes the comprehensive competency review (CCR), a milestone for MS students in Clinical Research at the University of Pittsburgh's Institute for Clinical Research Education. The CCR involves metacognitive reflection of the student's learning as a whole, written evidence of each competency, a narrative explaining the choice of evidence for demonstrating competencies, and a meeting in which two faculty members review the evidence and solicit further oral evidence of competence. CCRs allow for individualized feedback at the midpoint in degree programs, providing students with confidence that they will have the means and strategies to develop competence in all areas by the summative assessment of competence at their thesis defense. CCRs have also provided programmatic insight on the need for curricular revisions and additions. These benefits outweigh the time cost on the part of students and faculty in the CCR process. © 2015 Wiley Periodicals, Inc.

  17. School District-University Cooperation in Competency-Based Inservice Teacher Education.

    ERIC Educational Resources Information Center

    Grunewald, Robert N.

    This article describes a jointly planned and jointly evaluated course offered through Washington State University General Extension. The purpose of the course was to improve instruction in elementary classrooms through use of competency-based training materials (Minicourses) from the Far West Laboratory for Educational Research and Development.…

  18. Building Intercultural Competence through Intercultural Competency Certification of Undergraduate Students

    ERIC Educational Resources Information Center

    Janeiro, Maria G. Fabregas; Fabre, Ricardo Lopez; Nuno de la Parra, Jose Pablo

    2014-01-01

    The Intercultural Competency Certificate (CCI in Spanish) designed for the Universidad Popular Autonoma del Estado de Puebla (UPAEP University) is a theory based comprehensive plan to develop undergraduate students' intercultural competence. This Certificate is based in the Developmental Model of Intercultural Sensitivity (DMIS) developed by…

  19. Development of a Systems Engineering Competency Model Tool for the Aviation and Missile Research, Development, And Engineering Center (AMRDEC)

    DTIC Science & Technology

    2017-06-01

    The Naval Postgraduate School has developed a competency model for the systems engineering profession and is implementing a tool to support high...stakes human resource functions for the U.S. Army. A systems engineering career competency model (SECCM), recently developed by the Navy and verified by...the Office of Personnel Management (OPM), defines the critical competencies for successful performance as a systems engineer at each general schedule

  20. Structural Equation Modeling of Cultural Competence of Nurses Caring for Foreign Patients.

    PubMed

    Ahn, Jung-Won

    2017-03-01

    This study aimed to construct and test a hypothetical model including factors related to the cultural competence of nurses caring for foreign patients. The transcultural nursing immersion experience model and anxiety/uncertainty management theory were used to verify the paths between the variables. The exogenous variables were multicultural experience, ethnocentric attitude, and organizational cultural competence support. The endogenous variables were intercultural anxiety, intercultural uncertainty, coping strategy, and cultural competence. Participants were 275 nurses working in general hospitals in Seoul and Kyung-Gi Do, Korea. Each nurse in this study had experience of caring for over 10 foreign patients. Data were collected using a structured questionnaire and analyzed with SPSS statistical software with the added AMOS module. The overall fitness indices of the hypothetical model were a good fit. Multicultural experience, ethnocentric attitude, organizational cultural competence support, and intercultural uncertainty were found to have a direct and indirect effect on the cultural competence of nurses while coping strategy only had a direct effect. Intercultural anxiety did not have a significant effect on cultural competence. This model explained 59.1% of the variance in the nurses' cultural competence when caring for foreign patients. Nurses' cultural competence can be developed by offering multicultural nursing education, increasing direct/indirect multicultural experience, and sharing problem-solving experience to promote the coping ability of nurses. Organizational support can be achieved by preparing relevant personnel and resources. Subsequently, the quality of nursing care for foreign patients' will be ultimately improved. Copyright © 2017. Published by Elsevier B.V.