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Clinical Competency Committees (CCC): Clinical Competency Committees (CCC):

Clinical Competency Committees (CCC): - PowerPoint Presentation

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Clinical Competency Committees (CCC): - PPT Presentation

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

committee program residents faculty program committee faculty residents amp director members chair ads evaluation meetings process directors residency year role chief support

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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…)