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Next Accreditation System and Milestones: Harvard Dermatology Status Update

Learn about the Harvard Dermatology program's transition to the ACGME's Next Accreditation System, focusing on competency-based milestones to evaluate resident performance effectively. The program updates aim to enhance educational quality and accountability towards stakeholders.

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Next Accreditation System and Milestones: Harvard Dermatology Status Update

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

  2. “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 21st century.” Nasca et al. NEJM 366;11:1051-56

  3. 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 team-oriented, 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 Nascaet al. The Next GME Accreditation System. Rationale and Benefits. NEJM 366;11:1051-56

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

  5. Clinical Competency Committee (CCC) • Meet q6mos 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

  6. Clinical Competency Committee (CCC)

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

  8. ACGME Next Accreditation SystemMilestones • 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 s44-70.

  9. To fill out evaluations!!!!!

  10. ACGME Next Accreditation SystemMilestones • “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 s44-70.

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

  12. 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!

  13. 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)—q6mos • Patient evaluations—q6mos • Self-Assessment--yearly

  14. ?

  15. APD Milestones Tools • 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 (ProCom JECA)

  16. 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

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

  18. Jennifer Huang Ines Wu Susan Burgin Daihung Do

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