ACGME OUTCOME PROJECT - GENERAL COMPETENCIES DOCUMENTATION
MEDICAL KNOWLEDGE
VCU Health System Residency Training Program:_____________________________
MEDICAL KNOWLEDGE:
Residents must
demonstrate knowledge
about established and
evolving biomedical,
clinical, and cognate (e.g.
epidemiological and socialbehavioral) sciences and the
application of this
knowledge to patient care.
Residents are expected to:
1. demonstrate an
investigatory and analytic
thinking approach to
clinical situations
2. know and apply the basic
and clinically supportive
sciences which are
appropriate to their
discipline
How does the program
deliver the opportunity for
resident(s) to develop this
competency?
How does the program
measure the resident(s)
development of this
competency?
How do you document the
delivery and/or attainment of
this competency by
residents?
 List of expected
competencies for each
rotation is distributed to
residents at the beginning of
the year/rotation.
 OSCEs/simulated patients
 360 Global Evaluation
 Monthly written rotation
evaluations (describe how
feedback gets to resident)
 Supervising faculty
questioning and appraisal
 Mock exam scores are kept
with the resident's file
 Review Course written
assessment
 Performance on Review
Course assessment
 Faculty/other
resident/student/other written
evaluations
 Development of resident
portfolio, reviewed with faculty
advisor (how often)
 Written evaluation of journal
club presentations
 Additional discussion of
progress with (how often)
meeting with Chairman or
Division Chair of Department
 Required Grand Rounds/
other didactic lectures
including information on:
________________________
________________________
________________________
________________________
________________________
________________________
____________
 Morbidity and Mortality
conferences held (how often)
to review missed information,
inappropriate management,
technical errors.
 Specialty-based exams
(list) given annually.
 Resident meets the SOM
Professionalism Standard
related to life-long learning to
 Departmental Educational
Review Committee evaluates
each resident annually (or how
often) and prepares a summary
 Scientific rationale for
proposed patient treatment
plan and management
decisions is reviewed by a
faculty member before
implementation.
 Mock exams to self
assess - remediation required
for those who score poorly
(describe remediation)
the satisfaction of faculty and
other colleagues.
of that appraisal that is
discussed with the resident
(how)
 List of scientific
meetings/presentations
attended maintained for each
resident
 OSCE/simulated patient
reports
 Review courses (for whom
and describe)
 360 Global Rating
Evaluation reports
 Residents attend local,
regional, national, scientific
meetings such as ________
to facilitate didactic learning
and stimulate discussion and
learning among colleagues
from other health centers.
 Annual/Quarterly formal
performance evaluations
 Residents participate in a
(how often) journal club and
are responsible for presenting
two articles each year. These
sessions are attended by a
faculty member.
 Consult services (name)
are available for information
and review while developing
treatment plans and
managing patient problems.
 All evaluations are added to
resident portfolio, reviewed with
faculty advisor (how often)
 Lack of reported instances of
unprofessional behavior as
defined by the SOM Standards
of Professional Behavior.
 Departmental Educational
Review Committee evaluates
each resident annually (or how
often) and prepares a summary
of that appraisal that is
discussed with the resident
(how)
 Residents are required to
present one scientific paper
each year at (name meeting).
 References readily
available to residents include
Departmental Library, (which)
University Library,
______________________.
 Instruction in the use of
instructional technology for
medical knowledge
availability of this resource for
this purpose at (all/most)
clinical sites. Instructional
technology resources include:
 SOM Professionalism
Initiative distributed to all
housestaff details SOM
standards for expected
professional behaviors,
including a commitment to
life-long learning.
7-13-04
 Self-directed learning is
supported by allowing ______
hours per week for study time
(or ______ days a year for
conference attendance, etc)
Adapted from T. Rauch, M.S., General Competencies Curriculum Project, EVMS
ACGME OUTCOME PROJECT - GENERAL COMPETENCIES DOCUMENTATION
PATIENT CARE
VCU Health System Residency Training Program:_____________________________
PATIENT CARE
Residents must be able to
provide patient care that is
compassionate, appropriate,
and effective for the
treatment of health
problems and the promotion
of health. Residents are
expected to:
1. communicate effectively
and demonstrate caring
and respectful behaviors
when interacting with
patients and their families
2. gather essential and
accurate information
about their patients
3. make informed decisions
about diagnostic and
therapeutic interventions
based on patient
information and
How does the program
deliver the opportunity for
resident(s) to develop this
competency?
 Daily opportunities to
practice and improve
interpersonal and
communication skills while
interviewing and counseling
patients and their families and
health care staff
 Faculty supervision of
interactions with patients,
families and healthcare staff
(how often)
 Daily opportunities to
observe faculty/other
residents interviewing and
counseling patients and their
families
How does the program
measure the resident(s)
development of this
competency?
 Supervising attending
(describe process in detail)
 Chart reviews
 Mock oral exams
 Written performance
evaluations
 Computer assisted
evaluation such as simulated
patient cases, sample exams,
PDA-based logs or
evaluations, surgical
simulators, etc.
 OSCEs
How do you document the
delivery and/or attainment of
this competency by
residents?
 Written resident performance
evaluations conducted (how
often and by whom - list).
Describe how information from
evaluations is formally shared
with residents.
 Documentation of patient
care skills during advisor
meetings
 Competency checklist or
patient log reviewed (how
often) by faculty
 Development of resident
portfolio, reviewed with faculty
advisor (how often)
 Patient surveys
 Faculty review of patient
 360 Global Rating
 Additional discussion of
preferences, up-to-date
scientific evidence, and
clinical judgment
care plans and management
decisions prior to final
decisions
4. develop and carry out
 Daily opportunities to
patient management plans communicate with patients
and their families about
5. counsel and educate
diagnosis and treatment plan
patients and their families
6. use information
technology to support
patient care decisions and
patient education
7. perform competently all
medical and invasive
procedures considered
essential for the area of
practice
8. provide health care
services aimed at
preventing health
problems or maintaining
health
9. work with health care
professionals, including
those from other
Settings where patient care
occurs include:
 inpatient
 outpatient
 emergency department
 _____________________
______________________
______________________
 Didactic lectures including
information on:
________________________
________________________
________________________
________________________
________________________
________________________
____________
 References readily
available to residents include
Departmental Library, (which)
consult services, on-line
Evaluation
 Patient logs
 Case presentations/M&M
 Resident meets the SOM
Professionalism Standards
related to interaction with
patients, faculty and other
members of the health care
team.
 Other formal written and
verbal feedback in addition to
performance evaluations
(describe process to ensure
this is done).
progress with (how often)
meeting with Chairman or
Division Chair of Department
 Lack of reported instances of
unprofessional behavior as
defined by the SOM Standards
of Professional Behavior.
 Departmental Educational
Review Committee evaluates
each resident annually (or how
often) and prepares a summary
of that appraisal that is
discussed with the resident
(how)
disciplines, to provide
patient-focused care
resources such as the
Library, Medline, MD Consult,
(list others), palm-based
resources including
______________________.
 Consult services (name)
are available for patient care
consultation while developing
treatment plans and
managing patient problems.
 Instruction in the use of
instructional technology for
patient care and availability of
this resource for this purpose
at (all/most) clinical sites.
Instructional technology
resources include:
 SOM Professionalism
Initiative distributed to all
housestaff details SOM
standards for expected
professional behaviors,
including interaction with
patients, faculty, and other
members of the health care
team.
 Residents work with other
professionals (e.g., nurses,
LCSWs, dietitians) to observe
and develop patient education
skills.
 Patient education
information available through
the following resources for
residents to
access:_________________
________________________
________________________
_______
 Daily opportunities to
interact with and observe
other health care disciplines
such as
_______________________
(give examples, e.g., rehab
therapists, chaplains, nurses,
discharge planners, dietary)
7-13-04
adapted from: T. Rauch, M.S., General Competencies Curriculum Project, EVMS
ACGME OUTCOME PROJECT - GENERAL COMPETENCIES DOCUMENTATION
PRACTICE-BASED LEARNING & IMPROVEMENT
VCU Health System Residency Training Program: _______________________________
PRACTICE-BASED
LEARNING &
IMPROVEMENT
Residents must be able to
investigate and evaluate
their patient care practices,
appraise and assimilate
scientific evidence, and
improve their patient care
practices. Residents are
expected to:
1. analyze practice
experience and perform
practice-based
improvement activities
using a systematic
methodology
2. locate, appraise, and
assimilate evidence from
scientific studies related
to their patients’ health
problems
3. obtain and use
information about their
How does the program
deliver the opportunity for
resident(s) to develop this
competency?
(check all that apply/space
provided to add information
or reorganize this
information)
How does the program
measure the resident(s)
development of this
competency? (check all that
apply)
How do you document the
delivery and/or attainment of
this competency by
residents? (check all that
apply & edit as necessary)
 Standardized Patient Eval
 Each resident meets with
his or her mentor 3-4 times per
year for evaluation sessions.
Pertinent evaluations and
checklists are reviewed, and
the results summarized in
writing.
 Record Review
 Evidence-based
lecture(s)/medical conference
 360 Global Rating
 Epidemiology conference
 Chart Stimulated Recall
 Journal Club has
evidence-based focus.
 Oral Exam
 Patient Survey
 IT Conference
 Critical Evaluation of the
Literature curriculum
 The program monitors
residents’ performance via
mentor meetings that compare
resident each quarter.
 Electronic medical record
 Each resident provided
with handheld pc and many
 Resident’s individual
performance, as well as in
comparison to other residents
 Delivery of information
regarding clinic operations, is
monitored with a sign-in sheet
as part of resident didactics.
 Information is tracked in
clinic by faculty supervisors and
shared with mentors as part of
Professional Development
portfolio.
 Delivery of information
own population of
patients and the larger
population from which
their patients are drawn
4. apply knowledge of
study designs and
statistical methods to the
appraisal of clinical
studies and other
information on
diagnostic and
therapeutic effectiveness
5. use information
technology to manage
information, access online medical information;
and support their own
education
6. facilitate the learning of
students and other
health care professionals
options for internet access.
 Residents receive PDA’s,
as PGY-1’s, and have access
to Web-CT and MD Consult
which enhances their medical
education
 Electronic library
 Palm library
 Practice-based clinical
conf
 Information obtained from
(literature search, Journal
Club, etc.) is then applied to
their patient population and
monitored by their faculty
supervisor in clinic. This
information is also shared
with their mentors as part of
their Professional
Development.
 Residents are expected to
deliver 2-3 lectures per year
to their peers.
 First year residents and
subsequent classes are
required to prepare a
scholarly paper.
in the program, is evaluated as
part of the resident’s
Professional Development
portfolio.
shared during resident didactic
sessions is monitored with a
sign-in sheet for Journal Club
and Evidence-based Medicine.
 Faculty supervisors
evaluate the application of
residents’ knowledge daily as
they supervise them in both in
and outpatient settings. This
information becomes a part of
the residents’ Professional
Development portfolio.
 The application of
knowledge of study designs is
monitored by faculty
supervisors and shared with
resident mentors as part of
residents’ Professional
Development.
 Annual research day.
 Competency based
procedural evaluation and
documentation.
 Other
________________________
________________________
________________________
 An overview of student
evaluations document resident
competency as facilitators of
learning to students.
 Journal Club Evaluation
Form
 Annual Resident Research
Day
 Medical student selection of
Resident Teacher of the Year
 Other _________________
_________________________
 Residents participate on
CQI hospital committees.
 Each resident is required
to make a grand rounds
presentation at least once per
year. These presentations
are based upon actual
individual cases encountered
in the resident’s clinical
experience. The presentation
emphasizes the skills of a
focused literature search,
state of the art practice, and
evidence-based medicine.
 Literature searches,
journal subscriptions,
research activities, computerbased collection, and data
organization.
 Didactic lectures include
evidence-based medicine,
various computer topics, and
resident Journal Club.
 Residents are required to
formulate a research precise
and submit a proposal of
study design suitable for
publication.
 Residents have daily
contact with medical students
and health care
professionals.
 Curriculum for Residents
as Teachers (sample)
1. Use of medical libraries;
2. Use of information
technology, including
Internet-based searches
and literature databases
(e.g., Medline);
3. Use of drug information
databases;
4. Active participation, as
appropriate, in educational
courses, conferences, and
other organized
educational activities both
at the local and national
levels.
 Reports can be run, by
resident by diagnosis code, in
order that residents might
review their patient panel and
perform case studies as
needed.
6-25-04
 Other
______________________
adapted from T. Rauch, M.S., General Competencies Curriculum Project, EVMS
ACGME OUTCOME PROJECT – GENERAL COMPETENCIES DOCUMENTATION
INTERPERSONAL AND COMMUNICATION SKILLS
VCU Health System Residency Training Program: _______________________________
INTERPERSONAL AND
COMMUNICATION
SKILLS
Residents must be able
to demonstrate
interpersonal and
communication skills
that result in effective
information exchange
and teaming with
patients, their patients
families, and
professional
associates. Residents
are expected to:
1. create and sustain a
therapeutic and
ethically sound
relationship with
patients
2. use effective
listening skills and
How does the program deliver
the opportunity for resident(s)
to develop this competency?
(check all that apply)
 Daily opportunities to practice
and improve interpersonal and
communication skills interacting
with patients and health care staff.
 Daily opportunities to develop
professional, ethical, and
humanistic approach while
interacting with patients and
health care staff.
 Daily opportunities to
communicate about patients by
writing in patient chart.
 Didactic presentations to ___
(1st, 2nd, 3rd) year residents on:
_______________________
___________________________
_________________________
How does the program
measure the resident(s)
development of this
competency? (check all that
apply)
How do you document the
delivery and/or attainment of
this competency by
residents? (check all that
apply)
 OSCE
 Performance evaluations
from
_________________________
_________________________
_________________________
______ (360 Global Rating,
Supervisor Feedback &
Simulated Patient Exercise, for
example) become part of the
resident’s portfolio. It is
documented in writing and with
verbal feedback to the resident
by
_________________(Program
Director or Mentor)
________________________
(annually/bi-annually/quarterly).
 Standardized Patient
 Patient Survey
 ABIM Patient Satisfaction
Questionnaire
 360 Global Rating
 Checklist
 Mock Oral Exams
 Faculty review charts, both
formally and informally (chart
reviews & during clinic time),
for writing skills.
 Additional discussion of
resident progress in
elicit and provide
information using
effective nonverbal,
explanatory,
questioning, and
writing skills
3. work effectively with
others as a member
or leader of a health
care team or other
professional group
 Faculty role modeling.
 SOM Professionalism Initiative
distributed to all housestaff details
SOM standards for expected
professional behaviors, including
humanistic treatment of patients,
students, and other members of
the health care team, maintaining
patient
confidentiality, privacy of
colleagues, and working with
others in a supportive manner.
 Resident meets all SOM
Professionalism Standards
related to communication,
confidentiality, privacy, and
working with other members of
the health care team to the
satisfaction of faculty and
other colleagues.
___________ (quarterly)
meetings with
_________________________
_________________________
(Mentor, Program Director or
Professional Development
Committee).
 Lack of reported instances of
unprofessional behavior as
defined by the SOM Standards
of Professional Behavior.

Other____________________
_________________________
 Other
 Other __________________
________________________ _________________________
________________________ _________________________
________________________ _________________________
________________________ _________________________
__________
____
Adapted from T. Rauch, M.S., General Competencies Curriculum Project, EVMS
 First year support group.
7-13-04
 Faculty review videotaped
encounters for effective
nonverbal and effective
listening skills.
ACGME OUTCOME PROJECT - GENERAL COMPETENCIES DOCUMENTATION
PROFESSIONALISM
VCU Health System Residency Training Program: ____________________________
PROFESSIONALISM
Residents must
demonstrate a
commitment to carrying
out professional
responsibilities,
adherence to ethical
principles, and
sensitivity to a diverse
patient population.
Residents are expected
to:
How does the program deliver
the opportunity for resident(s)
to develop this competency?
(check all that apply)
How does the program
measure the resident(s)
development of this
competency? (check all that
apply)
 Professionalism is modeled by
faculty, chief residents, nurses,
 Professionalism, adherence
preceptors, etc. (circle which
to ethical principles, and
apply)
sensitivity of the residents is
evaluated by direct observation
 ___________ lectures by the by faculty and
behavioral scientist and others
__________________________
present information on
(anyone else?) on a daily basis.
professionalism.
1. demonstrate respect,
 Faculty review videotaped
Curriculum includes lectures on:
compassion, and
encounters of residents to

professionalism
integrity; a
assess professionalism,
 medical ethics
responsiveness to
adherence to ethical principles,
the needs of patients  medical law
and sensitivity.
 communication
and society that
 OSCE/Standardized Patient
supercedes self Participation on Institutional or
interest;
Hospital Committee (circle which  Patient Survey
accountability to
apply) ____________________
patients, society, and __________________________
 ABIM Patient Satisfaction
the profession; and a (indicate name of committee, but Questionnaire
commitment to
must be professionalism-related)  Adapted ABIM MiniCEX
How do you document the
delivery and/or attainment of
this competency by
residents? (check all that
apply)
 Residents meet with their
faculty mentor/program director
(circle one) _______ (how
many times) per year. Various
evaluations are reviewed and
summarized in a written note
(revise this as necessary).
 Observation information
regarding professionalism,
adherence to ethical principles,
and sensitivity of the resident is
included on the Rotation
Evaluation Form (or indicate
other name of form).
 Lack of reported instances of
unprofessional behavior as
defined by the SOM Standards
of Professional Behavior.
excellence and ongoing professional
development
2. demonstrate a
commitment to
ethical principles
pertaining to
provision or
withholding of
clinical care,
confidentiality of
patient information,
informed consent,
and business
practices
 SOM Professionalism Initiative
distributed to all housestaff details
SOM standards for expected
professional behaviors and
periodically highlights one
standard with supporting
educational materials such as
cases and journal articles.
 Resident meets all SOM
Professionalism Standards to
the satisfaction of faculty and
other colleagues.
 Resident summarizes
Institutional or Hospital
Committee activities in an
annual 15 minute presentation
(revise as necessary).
 Other
_________________________
_________________________
_________________________
 Other
_____________________
3. demonstrate
sensitivity and
responsiveness to
patients’ culture, age,
gender, and
disabilities
7-13-04
adapted from T. Rauch, M.S., General Competencies Curriculum Project, EVMS
ACGME OUTCOME PROJECT - GENERAL COMPETENCIES DOCUMENTATION
SYSTEMS-BASED PRACTICE
VCU Health System Residency Training Program: _______________________
SYSTEMS-BASED
PRACTICE
Residents must
demonstrate an
awareness of and
responsiveness to the
larger context and
system of health care
and the ability to
effectively call on
system resources to
provide care that is of
optimal value.
Residents are expected
to:
1. understand how their
patient care and
other professional
practices affect other
health care
How does the program deliver
the opportunity for resident(s)
to develop this competency?
(check all that apply)
.
 Residents attend week long
Practice Management course.
 As early as orientation,
residents are exposed to costeffective treatment; taught proper
billing and coding methods.
 Residents have access to
reports exhibiting their ability to
generate positive cash flow.
 These issues are discussed
frequently in resident didactics to
create awareness of cost without
reducing quality.
How does the program
measure the resident(s)
development of this
competency? (check all that
apply)
How do you document the
delivery and/or attainment
of this competency by
residents? (check all that
apply)
 360 Global Rating
 Each resident meets with
his or her faculty supervisor
____ (times) per year.
Pertinent evaluations and
checklists are reviewed, and
the results summarized in
writing.
 Standardized Patient
 Chart Stimulated Recall
 Checklist
 Record Review
 Faculty supervisory
evaluations in the inpatient
 Patient Survey
and outpatient setting reflect
the level of resident
 Faculty supervisors monitor
understanding of this
residents’ understanding of
competency.
patient care and how it directly
affects the system.
 Reports can be run by
resident that exhibit proper
professionals, the
health care
organization, and the
larger society and
how these elements
of the system affect
their own practice
2. know how types of
medical practice and
delivery systems
differ from one
another, including
methods of
controlling health
care costs and
allocating resources
3. practice costeffective health care
and resource
allocation that does
not compromise
quality of care
4. advocate for quality
patient care and
assist patients in
dealing with system
complexities
 Health care costs are
discussed frequently during
resident didactics.
 Faculty, serving as role
models, would certainly afford the
best opportunity for residents to
witness cost-effective healthcare
in practice.
 Residents regularly deal with a
multi-system, multi-task health
care arena that provides them
ample opportunities, if sought
after, with understanding the
components of well thought out
patient management and efficient
health care delivery system with
effective cost management and
quality medical care.
 Daily opportunities to be a
patient advocate and provide
information and coordination to
the patient for his or her own
understanding and ability to deal
with the multifaceted and
sometimes problematic dealings
with health care managers and
 Residents are able to view
different practice styles as
they are supervised by
different faculty.
 As faculty supervise
residents in the inpatient and
outpatient settings,
discussions of cost-effective
healthcare are an active part
of that discussion.
coding, etc. This information
will also show them how
much revenue was generated
(as if they were in their own
practice).
 Supervising faculty, both
inpatient and outpatient,
evaluate residents’
accomplishment regarding
cost-effective, yet quality
healthcare.
 As faculty supervise
residents, they can review how  Faculty, while assessing
the resident is handling quality resident/patient encounters
of care issues, etc.
on an
 Knowing how and when to
refer is one of the most critical
components of residency.
Faculty supervisors discuss
this issue with residents on a
daily basis.
 Over the ___# of years of
residency training an
increasing awareness and
demonstrated ability to deal
with system-based practice
should become evident to the
resident and supervisor with
 Evaluation, can document
if a resident has achieved
competency in dealing with
patients’ system complexities.
 Documentation of
residents’ assessment, etc.,
is accomplished via faculty
supervision in both inpatient
and outpatient settings. The
information obtained via the
evaluation forms is
maintained in the
Professional Development
5. know how to partner
with health care
managers and health
care providers to
assess, coordinate,
and improve health
care and now how
these activities can
affect system
performance
providers.
 Resident to design and
complete one project during their
tenure as a resident that deals
with a health care systems issue.
This project may be
stimulated by committee
experience, M & M
Conferences, or patient care
experiences. The project report is
to identify the problem, describe a
solution, and anticipate new
problems that the solution may
produce. Residents may work as
a team on these projects. Project
reports will be given during Grand
Rounds.
 Residents keep a log book of
complications that occur in their
practice throughout their
residency. The log will guide
them to describe the complication
and its active and latent causes.
It will also prompt them to indicate
system changes that could avert
such errors in the future or
mitigate their effects.
 Lecture Cycle (sample):
written documentation and
notations to this effect.
 Other:_________________
portfolio of each resident.
 Other
___________________
Resource Allocation and Cost
Effective Health Care;
Fundamentals of Managed Care;
Insurance Contracts;
Public Health Programs &
Population medicine
Quality Management;
Performance Evaluation &
Physician Profiling
 Residents maintain a Critical
Incident Log
 Other:___________________
6-26-04
adapted from T. Rauch, M.S., General Competencies Curriculum Project, EVMS