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Core competencies and professionalism in the educational setting

Residency Program Connection, April 26, 2005

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Dear residency program colleague:

Last week, I participated in an audioconference, hosted by HCPro, Inc., in which I discussed developing core competencies and professionalism in the educational setting. In this week's letter, I'd like to answer a question that came from an attendee of that audioconference who is interested in implementing some of the themes we talked about. The attendee asked the following question:

How can professionalism be taught to residents, and when will we know if patient outcomes have improved due to competency based education (CBE)?

The development of professionalism requires teaching physicians to successfully model the characteristics of professionalism, but this is not limited merely to the clinical setting. Professionalism can be modeled in the way we interact with students in our teacher-learner relationships as well. This is one reason why I am such a big fan of CBE--a model of education that states outcome competencies, provides instruction specific to competencies, provides data to learners on their success in achieving competency, and progresses through the progression complex competencies. CBE, by its very nature, models respect and safety. I would also point out that specific content teaching on medical ethics, cultural competency, and end-of-life issues are critical parts in the development of professionalism competency.

Regarding the connection between improved outcomes and CBE--I think that this is a hard thing to quantify, given the multifaceted nature of the problem. However, diminishing rates of medical errors, particularly those resulting from communication issues, are a good sign that your program is on the right track. On a one-on-one basis, you should assess patient's experiences and whether they felt that their physician cared about them. You should see increasing responses as competency is achieved.

That's all for this week!

All the best,

Hershey S. Bell, MD, FAAFP
Clincal Professor Family Medicine
Associate Dean for Faculty Development and Evaluation
Lake Erie College of Osteopathic Medicine

Editor's note: For more information about the audioconference mentioned above or to order a tape of the audioconference, call customer service at 800/650-6787.

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