Competency-Based Medical Education in the Internal Medicine Clerkship: A Report From the Alliance for Academic Internal Medicine Undergraduate Medical Education Task Force

Sara B. Fazio, Cynthia H. Ledford, Paul B Aronowitz, Shobhina G. Chheda, John H. Choe, Stephanie A. Call, Scott D. Gitlin, Marty Muntz, L. James Nixon, Anne G. Pereira, John W. Ragsdale, Emily A. Stewart, Karen E. Hauer

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

As medical educators continue to redefine learning and assessment across the continuum, implementation of competency-based medical education in the undergraduate setting has become a focus of many medical schools. While standards of competency have been defined for the graduating student, there is no uniform approach for defining competency expectations for students during their core clerkship year. The authors describe the process by which an Alliance for Academic Internal Medicine task force developed a paradigm for competency-based assessment of students during their inpatient internal medicine (IM) clerkship. Building on work at the resident and fellowship levels, the task force focused on the development of key learning outcomes as defined by entrustable professional activities (EPAs) that were specific to educational experiences on the IM clerkship, as well as identification of high-priority assessment domains. The work was informed by a national survey of clerkship directors. Six key EPAs emerged: generating a differential diagnosis, obtaining a complete and accurate history and physical exam, obtaining focused histories and clinically relevant physical exams, preparing an oral presentation, interpreting the results of basic diagnostic studies, and providing well-organized clinical documentation. A model for assessment was proposed, with descriptors aligned to the scale of supervision and mapped to Accreditation Council for Graduate Medical Education domains of competence. The proposed paradigm offers a standardized template that may be used across IM clerkships, and which would effectively bridge competency evaluation in the clerkship to fourth-year assessment as well as eventual postgraduate training.

Original languageEnglish (US)
Pages (from-to)421-427
Number of pages7
JournalAcademic Medicine
DOIs
StateAccepted/In press - Mar 1 2018

Fingerprint

medicine
education
paradigm
student
accreditation
learning
supervision
documentation
director
diagnostic
graduate
educator
resident
history
evaluation
school
experience

ASJC Scopus subject areas

  • Education

Cite this

Competency-Based Medical Education in the Internal Medicine Clerkship : A Report From the Alliance for Academic Internal Medicine Undergraduate Medical Education Task Force. / Fazio, Sara B.; Ledford, Cynthia H.; Aronowitz, Paul B; Chheda, Shobhina G.; Choe, John H.; Call, Stephanie A.; Gitlin, Scott D.; Muntz, Marty; Nixon, L. James; Pereira, Anne G.; Ragsdale, John W.; Stewart, Emily A.; Hauer, Karen E.

In: Academic Medicine, 01.03.2018, p. 421-427.

Research output: Contribution to journalArticle

Fazio, SB, Ledford, CH, Aronowitz, PB, Chheda, SG, Choe, JH, Call, SA, Gitlin, SD, Muntz, M, Nixon, LJ, Pereira, AG, Ragsdale, JW, Stewart, EA & Hauer, KE 2018, 'Competency-Based Medical Education in the Internal Medicine Clerkship: A Report From the Alliance for Academic Internal Medicine Undergraduate Medical Education Task Force', Academic Medicine, pp. 421-427. https://doi.org/10.1097/ACM.0000000000001896
Fazio, Sara B. ; Ledford, Cynthia H. ; Aronowitz, Paul B ; Chheda, Shobhina G. ; Choe, John H. ; Call, Stephanie A. ; Gitlin, Scott D. ; Muntz, Marty ; Nixon, L. James ; Pereira, Anne G. ; Ragsdale, John W. ; Stewart, Emily A. ; Hauer, Karen E. / Competency-Based Medical Education in the Internal Medicine Clerkship : A Report From the Alliance for Academic Internal Medicine Undergraduate Medical Education Task Force. In: Academic Medicine. 2018 ; pp. 421-427.
@article{0ef3a07bf70d4cba94ae59c4ef7f4e33,
title = "Competency-Based Medical Education in the Internal Medicine Clerkship: A Report From the Alliance for Academic Internal Medicine Undergraduate Medical Education Task Force",
abstract = "As medical educators continue to redefine learning and assessment across the continuum, implementation of competency-based medical education in the undergraduate setting has become a focus of many medical schools. While standards of competency have been defined for the graduating student, there is no uniform approach for defining competency expectations for students during their core clerkship year. The authors describe the process by which an Alliance for Academic Internal Medicine task force developed a paradigm for competency-based assessment of students during their inpatient internal medicine (IM) clerkship. Building on work at the resident and fellowship levels, the task force focused on the development of key learning outcomes as defined by entrustable professional activities (EPAs) that were specific to educational experiences on the IM clerkship, as well as identification of high-priority assessment domains. The work was informed by a national survey of clerkship directors. Six key EPAs emerged: generating a differential diagnosis, obtaining a complete and accurate history and physical exam, obtaining focused histories and clinically relevant physical exams, preparing an oral presentation, interpreting the results of basic diagnostic studies, and providing well-organized clinical documentation. A model for assessment was proposed, with descriptors aligned to the scale of supervision and mapped to Accreditation Council for Graduate Medical Education domains of competence. The proposed paradigm offers a standardized template that may be used across IM clerkships, and which would effectively bridge competency evaluation in the clerkship to fourth-year assessment as well as eventual postgraduate training.",
author = "Fazio, {Sara B.} and Ledford, {Cynthia H.} and Aronowitz, {Paul B} and Chheda, {Shobhina G.} and Choe, {John H.} and Call, {Stephanie A.} and Gitlin, {Scott D.} and Marty Muntz and Nixon, {L. James} and Pereira, {Anne G.} and Ragsdale, {John W.} and Stewart, {Emily A.} and Hauer, {Karen E.}",
year = "2018",
month = "3",
day = "1",
doi = "10.1097/ACM.0000000000001896",
language = "English (US)",
pages = "421--427",
journal = "Academic Medicine",
issn = "1040-2446",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Competency-Based Medical Education in the Internal Medicine Clerkship

T2 - A Report From the Alliance for Academic Internal Medicine Undergraduate Medical Education Task Force

AU - Fazio, Sara B.

AU - Ledford, Cynthia H.

AU - Aronowitz, Paul B

AU - Chheda, Shobhina G.

AU - Choe, John H.

AU - Call, Stephanie A.

AU - Gitlin, Scott D.

AU - Muntz, Marty

AU - Nixon, L. James

AU - Pereira, Anne G.

AU - Ragsdale, John W.

AU - Stewart, Emily A.

AU - Hauer, Karen E.

PY - 2018/3/1

Y1 - 2018/3/1

N2 - As medical educators continue to redefine learning and assessment across the continuum, implementation of competency-based medical education in the undergraduate setting has become a focus of many medical schools. While standards of competency have been defined for the graduating student, there is no uniform approach for defining competency expectations for students during their core clerkship year. The authors describe the process by which an Alliance for Academic Internal Medicine task force developed a paradigm for competency-based assessment of students during their inpatient internal medicine (IM) clerkship. Building on work at the resident and fellowship levels, the task force focused on the development of key learning outcomes as defined by entrustable professional activities (EPAs) that were specific to educational experiences on the IM clerkship, as well as identification of high-priority assessment domains. The work was informed by a national survey of clerkship directors. Six key EPAs emerged: generating a differential diagnosis, obtaining a complete and accurate history and physical exam, obtaining focused histories and clinically relevant physical exams, preparing an oral presentation, interpreting the results of basic diagnostic studies, and providing well-organized clinical documentation. A model for assessment was proposed, with descriptors aligned to the scale of supervision and mapped to Accreditation Council for Graduate Medical Education domains of competence. The proposed paradigm offers a standardized template that may be used across IM clerkships, and which would effectively bridge competency evaluation in the clerkship to fourth-year assessment as well as eventual postgraduate training.

AB - As medical educators continue to redefine learning and assessment across the continuum, implementation of competency-based medical education in the undergraduate setting has become a focus of many medical schools. While standards of competency have been defined for the graduating student, there is no uniform approach for defining competency expectations for students during their core clerkship year. The authors describe the process by which an Alliance for Academic Internal Medicine task force developed a paradigm for competency-based assessment of students during their inpatient internal medicine (IM) clerkship. Building on work at the resident and fellowship levels, the task force focused on the development of key learning outcomes as defined by entrustable professional activities (EPAs) that were specific to educational experiences on the IM clerkship, as well as identification of high-priority assessment domains. The work was informed by a national survey of clerkship directors. Six key EPAs emerged: generating a differential diagnosis, obtaining a complete and accurate history and physical exam, obtaining focused histories and clinically relevant physical exams, preparing an oral presentation, interpreting the results of basic diagnostic studies, and providing well-organized clinical documentation. A model for assessment was proposed, with descriptors aligned to the scale of supervision and mapped to Accreditation Council for Graduate Medical Education domains of competence. The proposed paradigm offers a standardized template that may be used across IM clerkships, and which would effectively bridge competency evaluation in the clerkship to fourth-year assessment as well as eventual postgraduate training.

UR - http://www.scopus.com/inward/record.url?scp=85044291163&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044291163&partnerID=8YFLogxK

U2 - 10.1097/ACM.0000000000001896

DO - 10.1097/ACM.0000000000001896

M3 - Article

C2 - 28930762

AN - SCOPUS:85044291163

SP - 421

EP - 427

JO - Academic Medicine

JF - Academic Medicine

SN - 1040-2446

ER -