Evaluating Systems‐based Practice in Emergency Medicine

Abstract

The Accreditation Council for Graduate Medical Education has required that training programs initiate an evaluation process to assess resident acquisition of the newly promulgated general competencies (GCs). Certain GCs (e.g., systems‐based practice, problem‐based learning and improvement) are somewhat more challenging to define and measure than others. Systems‐based practice essentially captures the interactions of the emergency medicine resident that expand beyond isolated contact with the patient. Evaluating these various interactions is readily accomplished using a detailed ordinal evaluation form that measures commonly occurring easily identified actions. Examples of measurable items and the method by which they can be integrated into an evaluation device are presented.

Developing a Valid Evaluation for Interpersonal and Communication Skills

“…In addition, evaluating behaviors that frequently are seen, easily observed, and directly reflect the competency being surveyed is highly desired when measuring the clinical behavior of a physician in training. 9 Finally, Whelan et al have established that observational methods are valid for measuring ICS. 10 If an evaluation process is valid, it should discriminate between skilled and unskilled communicators.…”

Teaching Residents Systems-Based Practice Through a Hospital Cost-Reduction Program: A "Win–Win" Situation

“…[4][5] One program described a potential curriculum with practical applied exercises to develop systems thinking among family practice residents, but outcomes from that curriculum were not provided. 6 Franklin described the importance of physicians, and especially trainees, in being trained in the "pharmacoeconomics" of their institutions, to allow them to "drive" the formulary decisions based on cost-effectiveness.…”

An Evaluation of Emergency Medicine Resident Interaction Time with Faculty in Different Teaching Venues

“…[8][9][10][11] This theoretically permits direct observation of the EM resident, an assessment method believed by EM educators to be the most desirable assessment tool for components of the core competencies of patient care, interpersonal and communication skills, systems-based practice, and professionalism. 7,8,10,12 Swing noted higher reliability of assessments performed when there is observation of the resident engaged in clinical tasks, and the faculty uses taskspecific performance criteria such as checklists. 3 Larkin noted that ''Role models and the combined comments of multiple observers can also help assess clinical ethical capacity'' in discussing methods for evaluating professionalism in EM residents.…”