3 different perspectives Sharon Dabrow Pediatrics PD Cuc Mai Internal Medicine PD Todd Kumm Radiology PD ACGME requirements amp CCC Required in the Next Accreditation System A trained group who can make assessments of the competency of a resident based on milestones and the evaluation t ID: 572991
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Slide1
Clinical Competency Committees (CCC):3 different perspectives
Sharon Dabrow: Pediatrics PD
Cuc Mai: Internal Medicine PD
Todd Kumm: Radiology PDSlide2
ACGME requirements & CCC
Required in the Next Accreditation System
A trained group who can make assessments of the competency of a resident based on milestones and the evaluation tools used within the residency. Slide3
Questions to Answer…
Who
serves (any role for residents, chiefs) and how large
Role
of
Program Director
Role
of committee members and how frequent the committees are meeting
Faculty Development & Support
Administrative support
The phase in processSlide4
Diagnostic RadiologyHow in the world can I do this?Slide5
Building the CCC…
DATA
EDUCATION
FACULTY
PLAN
TIME AND ORGANIZATION …
ADS
ADS
ADS
In March of 2012
I began to build our “CCC”Slide6
Diagnostic Radiology 32 residents
2 chief residents (PL5)
1 Assoc. Program Director
Work at TGH, Moffitt, JAHVA, ACH & Bay Pines
“Site Director”
Faculty assigned as “educational leader” at each siteSlide7
Committee StructureProgram Director
3 Core Clinical Faculty (TGH, MCC & JAHVA)
Appointed for minimum 2 year term
Selected by site director; approved by PD
Chief Residents not involved
Department chair
Included initially as resident advocate
Program CoordinatorSlide8
Program Directors RoleProgram Chair = Program Director
Establish “charter” for the CCC
Member responsibilities
Define term of members
Set date & time of CCC meetings
Work with Program coordinator to ensure “upload” of milestone data to ACGME ADS
Revise & update evaluation process to match MILESTONESSlide9
The CCC “Charter” was draftedSlide10
Committee “roll-out”Committee members selected
Easier than I expected
Confirmed commitment and “TIME” of committee members
Supported by Chair & site directors
Sufficient time for meaningful review of resident & data
Committee informational & educational meetings
Quarterly prior to December 2013Slide11
And then I waited. . . Slide12
Minor setback. No big deal
FACULTY
PLAN
TIME AND ORGANIZATION …
ADS
ADS
ADS
ACGME
EDUCATION
DATASlide13
Timeline for “roll-out”
This is going to be a piece of cake!
Educate
Organize
Evaluate & Submit to ADS!Slide14
So it’s December. Let’s get back on track…
Work on the education
Educate
Organize
Evaluate & Submit to ADS!Slide15
From Competencies to Milestones…Slide16
Don’t forget the RESIDENTSSlide17
Resident Education & DevelopmentSlide18
Resources
Remember, you are not alone.
Annual Meetings (ACGME & Specialty meetings)
Networking with other program directors
Program Director AssociationsSlide19
Sharon Dabrow M.D.
PROGRAM DIRECTOR
PEDIATRIC RESIDENCY PROGRAMSlide20
Pediatrics 54 residents
2 PL3 chief residents
2 Assoc. Program Directors (1 ACH faculty)
Work at All Children’s Hospital, TGH and many out patient locations Slide21
Committee StructureProgram Director, Chair
2 Assoc. Directors
2 Chief Residents
3-4 Additional Faculty—chosen from the Core faculty.
Faculty appointed for 2-3 year term
Per ACGME--(Can include non-physician faculty or PL3 if desired)Slide22
Program Director’s RoleDetermine goals and organizational structure
Ensure files and data available for review
Work closely with office staff in preparation
Can vote
Reviews and determines remediation plan when necessary and ensures complianceSlide23
Committee Members Meet at minimum twice per year. May increase to quarterly
May be required to review and follow a subset of residents during their term; mentor them?
Must understand milestones and competencies
Must have time to attend meetings
What else can they do?
Serve as observer for SCOs, mentor for various activities, serve as core evaluators. Could be responsible for coordination all materials.
Slide24
Faculty Devp./Support
Need to learn about new requirements and NAS. Should attend fac.
devp
workshops, etc.
PD to provide education as neededSlide25
Administrative Support Residency coordinators critical
Present at all meetings; must take specific minutes that should be reviewed by PD and placed in res. fileSlide26
Internal Medicine ResidencyCuc
Mai MD
Program DirectorSlide27
Morsani College of Medicine Internal Medicine Residency Program
85 residents across 3 years
Inpatient rotations available at 3 different affiliate sites and another outpatient ambulatory site
4 Associate Program Directors with potentially 3 fourth year chief residents Slide28
Who serves on our committee?Committee chair is assigned by program director. Chair is usually an associate program director.
All associate program directors, all site directors, 4
th
year chief residents, and 2 additional chair appointed faculty members. Currently 9 members.
Appointed faculty members serve a two year term.Slide29
What is Program Director’s role?
Assigns chair of committee.
Serves as non-voting member and mainly resident advocate.
Has final decision on remediation recommendations made by committee.Slide30
Committee Member Duties and Roles
Currently meeting every 3 months. Meetings usually last 2 hours.
Committee Chair has been presenting and reviewing files for discussion. However, ultimately will assign smaller group to review files. Assignment will be based on residency class.
Also, committee is now given task of evaluating our evaluation system and making appropriate changes.Slide31
Faculty Development & Support
Started by sending committee chair to American Board of Internal Medicine (ABIM) faculty development workshop on evaluation.
In the process of developing and using the ABIM workbook for continuous development.
(
Holmboe
and Hawkins.
Practical Guide to the Evaluation of Clinical Competence
. )
Plan on sending a committee member to the ABIM workshop every year.Slide32
Administrative SupportResidency coordinator present at all meetings
Documentation of minutes
Gives another perspective on professionalism competencySlide33
What we have learned?Committee members benefit from faculty development and co-mentoring on the evaluation process.
We have been able to identify residents at risk earlier and remediating residents earlier takes additional resources to improve resident’s success.
Have identified areas for improvement in our evaluation system and are still working on milestones evaluations.
Could use committee members as mentor or direct observers especially in scenarios where evaluation is inconsistent.Slide34
Conclusions from all of our experiences
Committee decisions can improve accuracy and timeliness of evaluations and contribute to more accurate and appropriate remediation plans.
Many ways to design your CCC. Details need to fit the needs of your program and residents.
The process should be dynamic; focused on improving weaknesses in the process (evaluation system, faculty understanding of milestones, remediation process, etc…)