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Institutional Core Competency Plan

July Insert Year

Purpose

To create an internal process that outlines the methodology by which Insert Program/Hospital Name(Insert Program/Hospital Name Abbreviation) will achieve compliance with implementation and evaluation of activities as required by the American Osteopathic Association’s (AOA) Core Competency Compliance Program.

The Insert Program/Hospital Name Abbreviation Institutional Core Competency Plan (ICP) is an outline for promoting continual improvement in the medical education programs as well as measuring competency of our interns and residents based on the seven core competencies as defined by the AOA. The seven core competencies are:

1.Osteopathic Principles and Practice (OPP) and Osteopathic Manipulative Medicine (OMM);

2.Medical knowledge;

3.Patient care;

4.Professionalism;

5.Interpersonal and communication skills;

6.Practice based learning and improvement; and

7.Systems based practice.

Competency in a medical profession is defined as the appropriate, habitual and judicious use of knowledge, skills, resources and experience, leading to the improved quality of health care for our patients, appropriate utilization of the individual’s and society’s resources, advancements in lifelong learning, and greater satisfaction in practice for clinicians.

Institutional Commitment

Insert Program/Hospital Name Abbreviation is committed to the tenants of the AOA’s Core Competency Compliance Program and pledges its support through the allocation of personnel and resources to ensure the successful implementation of the program.

Insert Program/Hospital Name Abbreviationis dedicated to achieving a standard of excellence in our training programs. In order to graduate osteopathic physicians who are knowledgeable, skilled and motivated to meet the health care needs of the public,our institution is committed to the development, continuous assessment and improvement of our graduate medical education programs, and to have a highly skilled, prepared and motivated faculty, while striving for excellence in our training programs.

Oversight Responsibility

It is the responsibility of the Insert Program/Hospital Name Abbreviation director of medical education (DME) to review and update the ICCP annually. The Osteopathic Graduate Medical Education (OGME) committee of Insert Program/Hospital Name Abbreviation is charged with approving the ICCP and the performance of its trainees.

The internship director, the director of each residency program, and the program faculty are responsible for the implementation of the ICCP. The DME, the administrative director of medical education (ADME), and the medical education office staff will collate, review and input information for the annual report and plan updates. The trainee programs will participate in the development and integration of the ICCP for Insert Program/Hospital Name Abbreviation. This will be accomplished and monitored through the monthly OGME meetings and quarterly meetings of the trainees with each program director.

Each program will establish and publish in its Trainee Manual the appropriate expectations and benchmarks for the trainee, for each year of training and for each of the seven AOA Core Competencies. One of those expectations is that all trainees will be required to pass the COMLEX Level 3 examination before they are allowed to begin the OGME-3 year of training.

Collaborative Efforts with OMNEE

The implementation and evaluation of the outcomes of the Insert Program/Hospital Name Abbreviation ICCP will be a collaborative effort between the OMNEE and the Insert Program/Hospital Name.

Effectiveness

The effectiveness as well as the progress of the plan will be monitored as follows:

1.The program directors will review monthly:

a.Trainee and preceptor evaluations;

b.Results of in-service exam, OSCE, end-of-rotation or other substantive evaluation scores; and

c.Reports of the day-to-day progress of trainees.

1.

2.The office of medical education or the DME will review:

a.A summary of the monthly trainee and attending preceptor evaluations; and

b.The semi-annual evaluations of each trainee that are provided by the program directors.

1.

2.

3.The office of medical education or the DME will make appropriate suggestions for modifications in the training or remediation. The OGME committee may require remedial education or other corrective measures for trainees who are not making satisfactory progress or have other identified deficiencies.

A report on the progress of the trainees will be made at least semi-annually to the hospital OGME and forwarded to the OMNEE OGME. An annual summary report on the status of each trainee in meeting the established competencies will be made to the hospital OGME with a copy to be forwarded to the OMNEE.

Teaching Methods

OMM/OPP, medical knowledge, patient care, professionalism, interpersonal and communication skills,practice-based learning and improvement, and systems-based practice:

  • Teaching of the trainee will be done through a variety of methods involving passive, active, interactive learning, and team-based learning, progressively independent yet supervised learning opportunities, the utilization of didactive presentation, standardized patients, and interactive computer based module.
  • At the start of each year, a series of “critical” topic presentations, skills workshops and assessments are conducted to ensure that the trainee is prepared to provide patient care in a safe and effective manner for anticipated critical conditions.
  • Interactive learning opportunities occur regularly in conjunction with the provision of medical care to the institution’s patients and trainees, faculty and staff.
  • Trainees are required to attend scheduled educational sessions that are provided regularly in conjunction with morning report, other scheduled daily events, such as Journal Club, Grand Rounds, department education sessions, and during protected education days.
  • Independent research, synchronous and asynchronous learning utilizing electronic resources and case based modules are utilized to advance learning.
  • Simulation and standardized patient (SP) modules are utilized to advance learning and evaluate knowledge and skills.
  • Journal Club, participation an appropriate specialty approved textbook review sessions, Mortality and Morbidity Conference, Tumor Boards, Grand Rounds, Board Review sessions, and discipline specific conferences such as EKG or Radiology conferences are all utilized to assess knowledge and skills as well as to advance the trainee’s education.

Evaluation Methods for AOA Core Competencies (Exhibit A)

Core Competency 1 – Osteopathic Concepts

Trainees will be evaluated with/through:

  • Observations by the faculty during patient care and hands on laboratory experiences;
  • 360 review from patients, peers and staff;
  • Review of history and physical examinations and patient charts;
  • Procedure case logs;
  • Portfolios;
  • Patient outcomes as documented in chart review;
  • Performance during OSCE evaluations utilizing SP or simulation experiences;
  • Performance on computer assisted, cased-based modules; and
  • In-service or end-of-rotation examination.

Core Competency 2 – Medical Knowledge

Trainees will be evaluated with/through:

  • Observations by the faculty during patient care experiences;
  • 360 review from patients, peers and staff;
  • Review of patient chart orders and notes;
  • Portfolios;
  • Patient outcomes as documented in chart review;
  • Performance during OSCE evaluations, SP, or simulation experiences;
  • Performance on computer assisted, case-based modules;
  • In-service or end-of-rotation examinations;and
  • Performance on COMLEX Level 3 and Certification examinations when available.

Core Competency 3 – Patient Care

Trainees will be evaluated with/through:

  • Observations by the faculty during patient care experiences;
  • 360 review from patients, peers and staff;
  • Review of patient chart orders and notes;
  • Patient outcomes as documented in chart review;
  • Performance during OSCE evaluations, SP or simulation experiences;
  • Performance on computer assisted, case-based modules;
  • Portfolios
  • In-service or end-of rotation examinations;
  • Monthly and semi-annual evaluations that query the program’s faculty and staff to quantify their observations regarding the trainee’s knowledge and abilities to provide patient care within the health care system; and
  • Patient outcomes compared against national standards utilizing quality assessment tools such as patient registries, safety and quality programs.

Core Competency 4 – Professionalism

Trainees will be evaluated with/through:

  • Timeliness and compliance with policies, rules, and procedures established by the program, the institution, the profession, and other state and federal regulations;
  • Faculty observations of actions and attitudes during patient care experiences, educational and social events at the institution;
  • Participation in institutional, professional or community organizations and events;
  • Leadership roles at the institution or in professional organizations;
  • 360 review from patients, peers and staff;
  • Performance during OSCE evaluations, SP or simulation experiences;
  • Performance on computer assisted, case-based modules;
  • Portfolios;
  • In-service or end-of-rotation examinations; and
  • Monthly and semi-annual evaluations that query the program’s faculty and staff to quantify their observations about the trainee’s professionalism.

Core Competency 5 – Interpersonal and Communication Skills

Trainees will be evaluated with/through:

  • Faculty observations of actions and attitudes during patient care experiences; educational and social events at the institution;
  • Participation in institutional, professional or community organizations and events;
  • Leadership roles at the institution or in professional organizations;
  • 360 review from patients, peers and staff, and review of patient charts and records;
  • Performance during OSCE evaluations, SP or simulation experiences;
  • Performance on computer assisted, case-based modules;
  • Portfolios;
  • In-service or end-of-rotation examinations; and
  • Monthly and semi-annual evaluations that query the program’s faculty and staff to quantify their observations regarding the trainee’s interpersonal and communication skills.

Core Competency 6 – Practice-Based Learning and Improvement

Trainees will be evaluated with/through:

  • Faculty observations of actions and attitudes during patient care experiences;
  • 360 review from patients, peers and staff;
  • Performance during OSCE evaluations, SP or simulation experiences;
  • Performance on computer assisted, case-based modules;
  • Portfolios;
  • In-service or end-of-rotation examinations;
  • Monthly and semi-annual evaluations that query the program’s faculty and staff to quantify their observations regarding the trainee’s critical thinking and evaluative skills in clinical practice and his/her ability to integrate evidence-based traditional and osteopathic medical principles into patient care;
  • Patient outcomes compared to previous performance and national standards utilizing quality assessment tools such as patient registries, safety and quality programs;
  • Utilizing and incorporating current and appropriate medical literature in presentations of clinical cases during morning report and on rounds with the attending; and
  • Quality of assigned educational presentation to peers, staff and faculty during Journal Club, Mortality and Morbidity Conference, Tumor Boards, Grand Rounds, and protected education sessions.

Core Competency 7 – System-Based Practice

Trainees will be evaluated with/through:

  • Faculty observations of actions and attitudes during patient care experiences;
  • 360 review from patients, peers and staff;
  • Performance during OSCE evaluations, SP or simulation experiences;
  • Performance on computer assisted, case-based modules;
  • Portfolios;
  • In-service or end-of-rotation examinations;
  • Monthly and semi-annual evaluations that query the program’s faculty and staff to quantify their observations regarding the trainee’s ability to work in an efficient and effective manner within the health care system for the benefit of the patient;
  • Trainee’s knowledge and the application of that knowledge of individual and population based treatments;
  • Patient outcomes compared to previous performance, peers, and national standards utilizing quality assessment tools such as patient registries, safety and quality programs;
  • Utilizing and incorporating options for care available through medical system and discussing those options in the presentation of management and evaluation process for clinical cases during morning report and on rounds with the attending;
  • The trainee’s ability to work in a team environment, his/her understanding of the skills and competencies of other health care providers and the proper utilization of their professional services in the care of the patient; and
  • The trainee’s incorporation and discussion of the principles, advantages and limitations of the health care system in assigned educational presentations to peers, staff and faculty during Journal Club, Mortality and Morbidity Conference, Tumor Boards, Grand Rounds, and protected education sessions.

Outcomes

  • To demonstrate competency in their specialty, all graduating trainees will meet the standards established by their specialty discipline certification board.
  • Graduating trainees will demonstrate their competency through the skills they acquired during their residency career, all of which will be necessary to maintain certification and licensure throughout their professional career.
  • All trainees will demonstrate holistic, patient centered, ethical practices during their training years and prior to graduation.
  • All trainees are expected to demonstrate progressive improvement in performance on in-service examinations, OSCE, SP or simulation examinations.
  • Each trainee will develop the necessary knowledge and skills to provide competent care to his/her patients within the scope of their discipline.
  • All graduating trainees will be prepared to enter fellowship training, if desired.
  • All graduating trainees will be prepared to enter private, independent practice.

Subspecialty/Fellowship

A competency based education is essential to ensure that fellows are acquiring the knowledge and skills required of the discipline. Independent active learning, case-based, practice based and didactic sessions focusing on the established competencies for the discipline are incorporated to build on the core competencies expected of all osteopathic physicians. Monthly and semi-annual evaluations by the program director and DME will provide feedback on acquisition of discipline required competencies and maintenance of compliance with the profession’s core competencies.

Remediation Plan

Trainees not meeting the published expectations and benchmarks on the core competency evaluations will be required to undergo a remediation program. This may occur independent of performance on an individual rotation or service. This program will be individually developed by the DME and the respective program directors to provide a mechanism for correcting the trainee’s deficiencies. The remediation plan will outline the specific deficiencies requiring correction and will be a confidential part of the trainee’s file. The plan may be removed from the trainee’s file when all deficiencies are corrected or may remain a permanent part of the file if there is a pattern of non-satisfactory progress on the part of the trainee.

Quality Improvement

Insert Program/Hospital Name Abbreviation will develop a continuous quality improvement process to evaluate each core competency. The Insert Program/Hospital Name Abbreviation ICCP will be re-evaluated and updated yearly by Insert Month. The ICCP and annual reports are to be made available to AOA evaluators during on-site accreditation reviews. The DME and program directors are responsible for the integration of the plan into their respective programs.

Hospital Review and Approval:

______Date: ______

Insert CEO's Name, and title (president, CEO)

Insert Hospital's name

Osteopathic Graduate Medical Education Review and Approval:

______Date: ______

Brian Kessler, DO

OMNEE Chief Executive Officer

Institutional Core Competency PlanPage 1

Approved:

Revised:

Exhibit A

Tracking Methods Used

360 Evaluation / OSCE/SP/Simulation / Faculty Observation & Monthly Service Evaluation / Procedure/Case Logs / Portfolios / Written Exam / Chart Review/Quality Index
OPP-OMM
Medical knowledge
Patient care
Interpersonal/communication skills
Professionalism
Practice-based learning & improvement
System-based practice

Institutional Core Competency PlanPage 1

Approved:

Revised: