Meisha K. Graham,Morehouse School of Medicine,Atlanta,GA,Sandra E. Moore,Morehouse School of Medicine,Atlanta,GA,Chevon Brooks,Morehouse School of Medicine,Atlanta ,GA
Background In 2007, The Accreditation Council for Graduate Medical Education (ACGME) created 6 core competencies to ensure residents in all disciplines were learning the necessary skills to provide quality patient care. These competencies have become the foundation of Graduate Medical Education and are the basis for how residents are evaluated. While the clinical years of medical school should serve as preparation for residency, medical students are not currently exposed to the ACGME Core Competencies until their intern year. Moreover, medical student evaluations traditionally focus on medical knowledge and patient care, placing little emphasis on communication, professionalism, systems based practice, and practice based learning. Our institution implemented a competency-based curriculum to expose fourth year medical students on an inpatient pediatric sub-internship to the ACGME Core Competencies.
Objective To prepare graduating students for competency-based assessments in residency, and to provide basic skills on how to perform the competencies effectively.
Methods The ACGME Core Competencies are discussed during the course orientation. Students are given assignments during the 4-week rotation that address each competency. (1) Medical Knowledge: Each week a case is posted on a social media site. The students have one week to complete each case. Medical knowledge is also evaluated on team rounds by the service attending. (2) Patient Care: Students maintain patient and procedure logs. Patient logs are reviewed for diversity of diagnoses and volume. Attending facilitated discussions on patient management are held throughout the course and skills are evaluated on team rounds by the service attending. (3) Systems Based Practice: Each student spends 1 day with nursing, respiratory therapy, social work, child life, pharmacy, and nutrition. Each service explains their role in the hospital and students assist them with their daily tasks. This is a hands-on experience after which students complete a self-reflective. On the self-reflective they explain how the service they rotated with contributes to the care team, instances when they would need to utilize the service, and how they could best assist the service in performing their duties effectively. (4) Practice Based Learning: Each student is taught basic article review. On the last day of the rotation, students lead a Journal Club on an article of importance to inpatient pediatrics. (5) Professionalism: Students complete an online professionalism module and an interactive professionalism case on the social media page. (6) Communication: Students are observed completing histories and physicals and are evaluated by families and nursing on their communication skills. Upon completion of the rotation, students receive a verbal and written competency-based evaluation.
Conclusion Students who have completed the rotation express increased understanding of competency-based evaluation on the end of rotation survey.
Discussion It will be necessary to investigate whether early knowledge of the competencies improves student performance during residency. Future studies could also address the incorporation milestone-based evaluations for medical students.