Next Accreditation System and Milestones Harvard Dermatology Status

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Next Accreditation System and Milestones: Harvard Dermatology Status Update Rachel Reynolds, MD Program Director

Next Accreditation System and Milestones: Harvard Dermatology Status Update Rachel Reynolds, MD Program Director Harvard Combined Dermatology Training Program

“Outcome-based accreditation process through which the doctors of tomorrow will be measured for their

“Outcome-based accreditation process through which the doctors of tomorrow will be measured for their competency in performing the essential tasks necessary for clinical practice in the 21 st century. ” Nasca et al. NEJM 366; 11: 1051 -56

ACGME Next Accreditation System (NAS) • New format for ACGME evaluation of programs •

ACGME Next Accreditation System (NAS) • New format for ACGME evaluation of programs • Response to increasing accountability to stakeholders (patients, payers, congress, the public) regarding the role of physicians in teamoriented, cost-effective, patient-oriented care • Phase I: July 2013 for seven specialties • Phase II: July 2014 Dermatology • System of continuous reporting to ACGME replaces “site-visit” model Nasca et al. The Next GME Accreditation System. Rationale and Benefits. NEJM 366; 11: 1051 -56

Program Changes ü Formation of a Program Evaluation Committee (PEC)---formerly Education Operations (Ed. Ops)

Program Changes ü Formation of a Program Evaluation Committee (PEC)---formerly Education Operations (Ed. Ops) committee. – Has oversight of educational content, program evaluation and program policies ü Development of a Clinical Competency Committee (CCC)—AY 2013 -14

Clinical Competency Committee (CCC) • Meet q 6 mos to review resident performance, evaluate

Clinical Competency Committee (CCC) • Meet q 6 mos to review resident performance, evaluate performance, form action plan, oversee corrective action • Feedback provided to resident 1: 1 with PD/APD • Submits semiannual reports to ACGME

Clinical Competency Committee (CCC) Title Name Site Program Director: Rachel Reynolds BIDMC Associate Program

Clinical Competency Committee (CCC) Title Name Site Program Director: Rachel Reynolds BIDMC Associate Program Director Med-Derm: Andy Werchniak BWH Affiliated Site Directors: Harley Haynes Faculty Directors: VA Marilyn Liang CHB Mayra Lorenzo MGH Siobhan Mannion Lahey Ruth Ann Vleugels BWH Peggy Wu BIDMC Mat Avram Laser Cosmetics/MGH Susan Burgin Education/BIDMC Daihung Do Surgery/BIDMC Su-Jean Seo* Derm Path/BIDMC

Clinical Competency Committee (CCC) • Per recent ACGME clarification, chief residents in their senior

Clinical Competency Committee (CCC) • Per recent ACGME clarification, chief residents in their senior year of training do not serve on the CCC

ACGME Next Accreditation System Milestones • Resident performance will be measured against specialty-specific, competency-based

ACGME Next Accreditation System Milestones • Resident performance will be measured against specialty-specific, competency-based milestones • Dermatology milestones developed and finalized by APD, ABD and Dermatology RRC • CCC responsible for assessment and reporting Turiansky GW, et al. The Dermatology Milestones Project. JGME March 2014 s 44 -70.

To fill out evaluations!!!!!

To fill out evaluations!!!!!

ACGME Next Accreditation System Milestones • “Milestones are knowledge, skills, attitudes…organized in a developmental

ACGME Next Accreditation System Milestones • “Milestones are knowledge, skills, attitudes…organized in a developmental framework from less to more advanced. . . descriptors and targets for resident performance from entry into residency through graduation. ” Turiansky GW, et al. The Dermatology Milestones Project. JGME March 2014 s 44 -70.

ACGME Competencies • • • Patient Care Medical Knowledge Practice-based Learning and Improvement Interpersonal

ACGME Competencies • • • Patient Care Medical Knowledge Practice-based Learning and Improvement Interpersonal and Communication Skills Professionalism Systems-based Practice

Milestones—important points • Milestone scores reflect a “new” range that correlates with training progress

Milestones—important points • Milestone scores reflect a “new” range that correlates with training progress • While level 4 is recommended milestones for graduation level, achieving level 4 in all milestones is NOT a graduation requirement • ACGME will expect to see a range of milestone scores for each resident and for each residency program!

 Evaluation of Residents: Current process • Competency-based end of rotation evaluations -General/medical derm

Evaluation of Residents: Current process • Competency-based end of rotation evaluations -General/medical derm rotations x 3 -Dermpath rotation -Procedural rotation • Competency-based mini Clinical Evaluation Exercise (mini-CEX)—q 6 mos • Patient evaluations—q 6 mos • Self-Assessment--yearly

APD Milestones Tools 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Consultation

APD Milestones Tools 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Consultation Letter Milestones Tool Patient Letter Milestones Tool Evidence-Based Practice Simple Excision & Repair Assessment Tool In-Office Diagnostics Evaluation Exercise (IODEX) In-Office Procedure Evaluation Exercise (IOPEE) Mini-Dermatopathology Evaluation Exercise (DPEX) Pediatric Dermatology Clinical Evaluation Exercise (CEX) Conference Didactic/Lecture Presentation Assessment Professionalism and Communication Journal Entry Competency Assessment (Pro. Com JECA)

Harvard Derm New Evaluation System • Consolidate best features of current evals, add APD

Harvard Derm New Evaluation System • Consolidate best features of current evals, add APD tools as warranted, develop new tools • Easily maps to milestones • More observation-based, higher quality evaluation • More meaningful feedback and evaluation

Harvard Derm New Evaluation System • Efficient delivery and collection across complex program •

Harvard Derm New Evaluation System • Efficient delivery and collection across complex program • Incorporate into New Innovations

Jennifer Huang Ines Wu Susan Burgin Daihung Do

Jennifer Huang Ines Wu Susan Burgin Daihung Do