Patient care: The basis of all competencies

Residency Program Insider, September 25, 2007

Want to receive articles like this one in your inbox? Subscribe to Residency Program Insider!

One of the challenges in documenting any individual competency is that they are all interrelated in some manner. For instance, you cannot evaluate practice-based learning and improvement without understanding the impact of systems-based practice on how the physician practices. Similarly, it is difficult to evaluate communication by itself, without evaluating professionalism and medical knowledge. The competency of patient care, then, overlaps with all other competencies, as it is the lynchpin of a physician's education and the reason for training well-rounded physicians-to ensure patients are receiving the best treatment possible.


Because patient care is the basis of our profession, all other competencies should improve patient care. The ACGME's expectations may be grouped into three components:



  1. Gather accurate and relevant information using the following skills:
    • Medical interviewing
    • Physical examination
    • Appropriate diagnostic workup
    • Access and use of information technology


  1. Synthesize and apply information in the clinical setting by doing the following:
    • Making informed recommendations about preventative, diagnostic, and therapeutic options and interventions that are based on both clinical judgement, scientific evidence, and patient preferences, and on an understanding of this knowledge
    • Prescribing, performing, and interpreting medical procedures relevant to the practice of the specialty


  1. Partner with patients in a manner that fosters the following:
    • Assessment and provision of continued care needs
    • Counseling and education of patients and families
    • Prevention of health problems
    • Health maintenance


When developing your curriculum, you will find more than adequate opportunity for not only teaching the competency of patient care, but also for its evaluation. For example, every patient encounter and every case conference are hands-on settings for teaching patient care.


Editor's Note: The above material is excerpted from A Practical Guide to Teaching and Assessing the ACGME Core Competencies by Ruth Nawotniak, MS, CTAGME, Elizabeth A. Rider, MSW, MD, FAAP, and Gary Smith, EdD, and published by HCPro, Inc.

Want to receive articles like this one in your inbox? Subscribe to Residency Program Insider!