Competency Evaluation
Forms
Karen M. Weidenheim, M.D.
Neuropathology
The Problem
• What do the competencies mean for a
small subspecialty program?
• How should the re-defined competency
criteria be measured?
• How can the required assessments be
performed efficiently?
• How can the assessment process be
made useful to both trainee and
Program Director?
#1: Patient Care in Neuropathology. Fellows must be able to
provide patient care that is compassionate, appropriate, and
effective for the treatment of health problems and the promotion of
health. In the context of neuropathology, this means recognizing
one’s personal responsibility to provide clear, accurate, and timely
consultations in the context of a medical team.
• Extent to which Resident communicates effectively and
demonstrates caring and respectful behavior when interacting
with patients, next of kin, technicians, secretaries, funeral home
personnel and others.
•
Observe the right of privacy about personal health
information in public places (elevator, hall, cafeteria)
•
Observes discretion during surgical procedures
•
Provides lay language answers to questions from
technicians, secretaries, funeral home personnel
•
Provide lay language answers to questions from families in a
caring and respectful manner
• Extent to which Resident gathers essential and accurate
information about their patients
•
Pertinent clinical history, imaging data and laboratory results
are available at sign-out
#1: Patient Care in Neuropathology. Fellows must . . . Recognize
one’s personal responsibility to provide clear, accurate, and timely
consultations in the context of a medical team (continued)
• Extent to which Resident makes an informed diagnosis
incorporating patient information, pathological/clinical judgment
and up-to-date scientific evidence.
•
Able to formulate a Neuropathology diagnosis in the context
of prognostic and therapeutic implications for the patient, the
clinical history and implications for family
• Extent to which Resident performs dissection and sectioning skills
necessary for diagnostic services
•
Able to remove brain and spinal cords at autopsy
•
Able to accurately describe and section gross neurosurgical
specimens
•
Able to accurately describe microscopic features
•
Able to evaluate special stains and their controls
#1: Patient Care in Neuropathology. Fellows must . . . Recognize
their personal responsibility to provide clear, accurate, and timely
consultations in the context of a medical team (continued)
• Extent to which Resident makes informed selections of diagnostic
tests, is able to counsel clinician on selection of additional testing,
and can take responsibility for the cost and ethical implications of
the tests recommended/ordered
•
Able to order appropriate work-up of case so as to arrive at
correct final diagnosis
•
Able to recognize cases that require additional testing of
tissue or body to counsel clinician on additional testing
• Extent to which Resident uses information technology to support
patient care decisions, especially searching the current literature
and Web for help in difficult diagnostic situation.
•
Effectively searches literature for information pertinent to a
given entity
•
Effectively searches Web for information pertinent to a given
case
Competency #2. Medical Knowledge in Neuropathology. Resident
must demonstrate knowledge about established and evolving
biomedical, clinical and cognate (epidemiological and socialbehavioral) sciences and the application of this knowledge to
patient care in neuropathology.
• Extent to which Resident knows and applies the basic and
clinically relevant sciences that are appropriate to the practice
of Neuropathology
•
Demonstrates knowledge of basic pathological processes
appropriate for level of training
•
Demonstrates organized approach to a case in context of
own knowledge base
•
Formulates appropriate differential diagnosis
•
Demonstrates knowledge of neuropathology facts
appropriate for level of training (See attached test)
#3. Residents must be able to investigate and
evaluate their patient care practices, appraise
and assimilate scientific evidence, and improve
their patient care practice.
• Residents are required to keep a log of cases in
which they found it necessary to look up a technical
or professional issue, including case number, date,
issue identified, by what means the problem was
solved (look up a specific article, call the
manufacturer of a reagent, ask a technician or
colleague for assistance).
• Case logged checked and found to be
acceptable/unacceptable by_____________.
#4: Interpersonal and communication skills in neuropathology.
Neuropathology fellows must be able to demonstrate excellent
interpersonal and communication skills that result in effective
information exchange and teaming with patients, patients’ families,
colleagues, technicians, secretaries, other residents, and students.
• Able to explain diagnosis and implications for therapy
– Observe interactions with Neurosurgeons and Neurologists
– Performance in clinical conferences
• Able to explain how to perform a diagnostic test (e.g., muscle and
nerve biopsies, brain biopsy, brain autopsy)
– Observe interactions with Neurosurgeons and their residents
– Observe interactions with general pathology residents
• Able to write diagnoses and reports in standard English
• Able to work with technicians to solve problems
– Observe interactions with technical staff
– Inquire about quality of interactions
• Pathologist Assistants
• Dieners
• Technicians
#4: Interpersonal and communication skills in neuropathology.
Neuropathology fellows must be able to demonstrate excellent
interpersonal and communication skills that result in effective
information exchange and teaming with patients, patients’ families,
colleagues, technicians, secretaries, other residents, and students.
• Is able to present clinical findings in patient-related conferences
– Direct observation with documentation by checklist
• Is able to present clinical and research data at professional
meetings
– Observation
– Documentation in conference proceedings
• Is able to publish clinical or research papers in peer-reviewed
journals
– Documentation in literature
– Curriculum vitae
– Resident’s portfolio
#5: Professionalism in neuropathology. Fellows must
demonstrate a commitment to carrying out professional
responsibilities, adherence to ethical principles, and sensitivity to
diverse populations. It is recognized that neuropathologists
interact only occasionally with patients and their families. More
frequent interactions include those with colleagues in pathology,
colleagues in neurology and neurosurgery, laboratory technicians,
secretaries, other residents and students.
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Respect for others
Honesty and integrity
Tolerance, sensitivity to differences
Altruism
Dutifulness
360o Evaluation
– Peers
– Subordinates
#5: Professionalism in neuropathology. Fellows must demonstrate
a commitment to carrying out professional responsibilities,
adherence to ethical principles, and sensitivity to diverse
populations. It is recognized that neuropathologists interact only
occasionally with patients and their families. More frequent
interactions include those with colleagues in pathology, colleagues
in neurology and neurosurgery, laboratory technicians, secretaries,
other residents and students.
• Able to admit and correct mistakes
• Successfully represents field of (Neuro)pathology
– Other Pathologists
– Neurology and Neurosurgery
– Other physicians
• Professional development
• Society at large
– Professional and personal actions are those of a good citizen
#6: Systems-based practice in Neuropathology. Fellows must
demonstrate an awareness of and responsiveness to the larger
context and system of health care. In neuropathology, the fellow
must be able to provide effective guidance to the clinicians directly
responsible for making treatment decisions and calling on system
resources. The fellow must be aware of the consequences to the
patient of the diagnosis and play an active role in assuring that the
appropriate care is provided. The fellow must be able to interact
successfully with technicians, clerical personnel and other
paraprofessional members of the laboratory and health care team to
obtain the best possible outcome for the patient.
• Extent to which Resident understands how their diagnostic
opinion and other professional practices affect other health
care professions, the organization and the larger society.
• Demonstrates awareness of clinical deadlines faced by clinical
services that rely on their diagnostic services
• Demonstrates awareness of cost of tests
#6: Systems-based practice in Neuropathology. Fellows must
demonstrate . . . responsiveness to the larger context and system of
health care. In neuropathology, the fellow must be able to provide
effective guidance to the clinicians directly responsible for making
treatment decisions and calling on system resources . . . be aware of
the consequences to the patient of the diagnosis and play an active
role in assuring that the appropriate care is provided . . . interact
successfully with technicians, clerical personnel and other
paraprofessional members of the laboratory and health care team to
obtain the best possible outcome for the patient.
• Able to allocate pathology resources in a way that does not
compromise quality of care
• Willing to advocate for quality patient care
– Day to day observation
– OSCE
#6: Systems-based practice in Neuropathology. Fellows must
demonstrate . . . responsiveness to the larger context and system of
health care. In Neuropathology, the fellow must be able to provide
effective guidance to the clinicians directly responsible for making
treatment decisions and calling on system resources . . . be aware of the
consequences to the patient of the diagnosis and play an active role in
assuring that the appropriate care is provided . . . interact successfully
with technicians, clerical personnel and other paraprofessional members
of the laboratory and health care team to obtain the best possible
outcome for the patient.
• Understands importance of using only CLIA-approved
laboratories for diagnostic testing
• Able to refer specimens to appropriately certified reference
laboratories for specialized testing
• Able to work with health care managers and providers to
assess, coordinate and improve health care in the context of
the clinical laboratory i.e. understands principles of Quality
Assurance in Anatomic Pathology
• Understands how to prepare a laboratory for inspection by the
CAP, JCAHO, or similar agency
Summary
• Helpful to resident
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Specific subjects to study
Specific experiences to look for
Specific behaviors that are expected of a physician
Motivation to document their successes in a
portfolio/curriculum vitae
• Helpful to Program Director
– Monitor of resident progress
– Specific areas of the program that need strengthening
– Motivation to develop focused, more efficient evaluation
methods
– Identification of areas of the program that may be irrelevant