ACGME In Practice 3

Table 2: Sample implemenation matrix matching specific tools to specific competencies.

Medical knowledge

What to Assess	How to Assess
Medical knowledge	OKAP scores Board scores
Application of medical knowledge	Oral exam score Chart stimulated recall on top 5 diagnoses

Patient care

What to Assess	How to Assess
Resident's overall patient care abilities in clinic	Global performance rating AND 360 o Assessment, to be completed by the resident, professional associates, and patients (unless patient care is not the primary activity of the specialty)
Clinical history and exam	Direct observation and evaluation of one complete patient encounter with checklist

Interpersonal and Communication Skills What to Assess How to Assess Resident's overall interpersonal and communication skills during a rotation Global performance rating AND 360 o Assessment, to be completed by the resident, professional associates, and patients Communication with outside physicians and patients by phone Focused observation and evaluation using phone tool checklist Professionalism What to Assess How to Assess Ethics knowledge University of Illinois Web based competency assessment including ethics vignettes with multiple choice and open-ended responses Professional behaviors 360° Assessment, to be completed by the resident, professional associates, and patients Sentinel events portfolio The learning environment Questionnaire completed by the residents Practice-based Learning and Improvement What to Assess How to Assess Processes and behaviors Reflection on practice and practice analysis Utilization of current literature A plan for change/improvement Portfolio with checklist assessment OR Discussion-based assessment (e.g., chart stimulated) with • Checklist/encounter card (preferred) OR • Global performance rating OR Journal Club tool (documentation of evidence based learning, written review for portfolio) Outcomes, i.e., performance improvements One record-based assessment with • Checklist/encounter card (preferred) OR • Global performance rating OR One discussion-based assessment with • Checklist/encounter card (preferred) OR • Global performance rating Portfolio Written learning plan Evidence of self directed learning Time management diary Sentinel events document Revised learning plan prompted by critical events Systems based care
What to Assess	How to Assess
Systems based care: interaction of ophthalmology and health care system including other providers	Web based vignette and portfolio documentation
2. Patient related systems based problem solving	Focused observation and evaluation

Surgery

What to Assess	How to Assess
Informed consent	Global performance rating AND Direct observation checklist
Identification of instruments	Web based tutorial
Surgical skills: critical events	Video review and critique with faculty surgeon of every intraoperative complication
Surgical technique	Direct observation checklist using global rating scale of operative performance (e.g. respect for tissue, time and motion, instrument handling, knowledge of instruments, flow of operation, use of assistants, knowledge of specific procedure)