PROFESSIONAL COMPETENCY INVENTORY 28 TH BEHAVIORAL SCIENCE FORUM BRUCE D. ROBERTSON, LCSW, MLSP; ASSISTANT CLINICAL PROFESSOR, UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE

OBJECTIVES IDENTIFY the ACGME/RRC Challenge CORRELATE to the Future of Family Medicine Vision DESCRIBE the components of Interpersonal Communication/Professionalism EXAMINE the role of Emotional Intelligence models IDENTIFY key implementation principles DISCUSS mutual challenges

THE ACGME CHALLENGE-2002 COMPREHENSIVE 360 DEGREE PROCESS IDENTIFY TEACH EVALUATE COMPETENCIES INTERPERSONAL COMMUNICATION PROFESSIONALISM

FUTURE OF FAMILY MEDICINE PROJECT-MEDICAL EDUCATION “Family Medicine (unlike other specialties) is not defined solely by content. The education of the Family Physician is one that emphasizes a PROCESS: the patient –physician relationship…”

FUTURE OF FAMILY MEDICINE PROJECT “The biopsychosocial model is more than just adding psychological data. It proposes a different method of CLINICAL REASONING …that is patient-centered, evidence-based, WHOLE PERSON care.”

FUTURE OF FAMILY MEDICINE PROJECT “Although family medicine has attempted to incorporate this model into training, it has yet to FULLY INTEGRATE this way of thinking into education and practice.”

FFM- PROFESSIONAL DEVELOPMENT TASK FORCE REPORT 3 “Proposes a plan for lifelong learning… to ensure that family physicians are prepared to deliver the core attributes… throughout their careers…within the New Model of family medicine”

SOME HISTORY ON PROFESSIONALISM General Professional Education of the Physician Report/ American Board of Internal Med Wisconsin Med/ Tulane Med Association of American Medical Colleges Wenner/Blonski- Minnesota Family Medicine/ Robertson- PSFMR- UW Chief Resident Conference Lattore- Professionalism in the Practice of Medicine - USC Kass- USUHS

PROFESSIONAL COMPETENCY MODEL (PCM) “E MOTIONALLY I NTELLIGENT” M ODEL FOR DEVELOPING COMPETENCIES I NTERPERSONAL C OMMUNICATION P ROFESSIONALISM I NTEGRATION- EXISTING FORMATIVE PROCESS B ASED ON ACGME O UTCOME G OALS

PROFESSIONAL COMPETENCY INVENTORY (PCI) FORMULA FUTURE OF FAMILY MEDICINE + ACGME COMPETENCIES + LEADERSHIP “CURRICULUM” + FITNESS REPORTS + EMOTIONAL INTELLIGENCE DEGREE DATA BASED PROCESS = Professional Competency Inventory

FUTURE OF FAMILY MEDICINE IMPLICATIONS: IDENTITY –what is a Family physician CORE VALUES –what beliefs drive us BEHAVIORAL SCIENCE INTEGRATION what competencies define us

ACGME COMPETENCIES SIX ACGME COMPETENCIES Patient Care Interpersonal / Communication Skills Medical Knowledge Professionalism Systems-based Practice Practice-Based Learning COMPUTER-BASED DOCUMENTATION (NEW INNOVATIONS) ROTATION FOCUSED

LEADERSHIP “CURRICULUM” O NE T EAM (IM) E VALUATION M ENTORING C OMMITTEES A RT OF M EDICINE A RT OF L EADERSHIP E DUCATIONAL E VALUATION- C OACHING

FITNESS REPORTS PROFESSIONAL EXPERTISE – proficiency ORGANIZATIONAL CLIMATE – growth, development, human worth, community MILITARY BEARING – fitness, core values (honor, courage, commitment) TEAMWORK – team building/results MISSION ACCOMPLISHMENT – taking initiative, planning, prioritizing LEADERSHIP – organizing, motivating

WHAT IS EMOTIONAL INTELLIGENCE? PER GOLEMAN - FOUR CLUSTERS/ 21 COMPETENCIES SELF AWARENESS EMOTIONAL ACCURATE CONFIDENCE SOCIAL AWARENESS EMPATHY ORG AWARENESS SERVICE SELF MANAGEMENT CONTROL TRUST CONSCIENTIOUS ADAPTIVE OPTIMISM ACHIEVEMENT INTIATIVE RELATIONSHIP MANAGEMENT DEVELOP OTHERS LEAD INFLUENCE COMMUNICATE CHANGE MANAGE CONFLICT BUILD BONDS TEAMWORK/COLLABORATION

EI in a “RESIDENT NUTSHELL” > Recognize behavioral dynamics of patients- empathy, conscientious, communication …(health behavior change skills) > Manage behaviors related to ourselves- self awareness, initiative > Manage our relationships with others- self regulation, conflict management > Completing tasks …together – collaboration, organizational awareness, change catalyst >Teaching- formative evaluation, coaching (Note: Webb, PhD/ Baumer, MD presentation, Paul Wenner)

USC STUDY- Anesthesia “Faculty find it difficult to deliver these competencies…not prepared to teach beyond didactic learning.” “Residents while willing to consider these competencies as important are reluctant to build them into their training program.” “Both have a difficult time understanding the nature of these competencies within a standard curriculum” Pat Lattore

PCI FORMULA FUTURE OF FAMILY MEDICINE + ACGME COMPETENCIES + LEADERSHIP “CURRICULUM” + FITNESS REPORTS + EMOTIONAL INTELLIGENCE DEGREE DATA BASED PROCESS = Professional Competency Inventory

360 DEGREE EVALUATIONS LOCALLY DEVELOPED TOOL COST EFFECTIVE ONLINE DATA COLLECTION QUARTERLY SURVEY

THE STRATEGY… DEVELOP COMMITMENT FOR C HANGE PLANT EMOTIONAL INTELLIGENCE (EI) AS EB M ODEL ADAPT EI MODEL/ INSTRUMENTS TO F IT O UR R ESIDENCY AND C ORE V ALUES

PCM PLAN OF ACTION Utilize ECI to introduce EI theory/practice Use WAMMI conferences for focus groups Reframe ECI to PCM through consensus Build On Line PCM Assessment Tool Conduct PCM Beta Test Integrate PCM as multi-modal 360 Validate Tool

PROFESSIONAL COMPETENCY MODEL (PCM) B ASED ON EVIDENCE - EI STRUCTURE C USTOMIZED FOR NAVAL RESIDENCY TRAINING D EFINED BY CONSENSUS (RESIDENT+FACULTY) 360 DEGREE COMPUTER-BASED PROCESS C ORRELATED TO PRACTICE SKILLS D EVELOPMENTAL

PROFESSIONAL COMPETENCY FIVE MISSION CLUSTERS LEARNING INTEGRATION CONSCIENTIOUSNESS EMPATHY MANAGING CONFLICT MANAGEMENT COMMAND AWARENESS TEAMWORK TEACHING FORMATIVE EVALUATION PRACTICE MODELING MENTORING LEADING COLLABORATION CHANGE CATALYST MILITARY ACUMEN SELF REGULATION : AWARENESS/ MANAGEMENT /COMMUNICATION

DEVELOPMENTAL / FORMATIVE EVALUATION SELF-REGULATION is essential for

DEVELOPMENTAL / FORMATIVE EVALUATION LEARNING is integral to SELF-REGULATIONis essential for

DEVELOPMENTAL / FORMATIVE EVALUATION TEACHING these 3 are critical for LEARNINGis integral to SELF-REGULATIONis essential for

DEVELOPMENTAL / FORMATIVE EVALUATION MANAGING all are prerequisites for TEACHINGthese 3 are critical for LEARNINGis integral to SELF-REGULATIONis essential for

DEVELOPMENTAL / FORMATIVE EVALUATION LEADING MANAGINGall are prerequisites for TEACHINGthese 3 are critical for LEARNINGis integral to SELF-REGULATIONis essential for

PROFESSIONAL COMPETENCY RESIDENCY DEVELOPMENTAL PHASES LEADING MANAGING TEACHING LEARNING SELF REGULATION MEDICAL TRAINING

MEDICAL PRACTICE PROFESSIONAL DEVELOPMENTCOMPETENCIES LEADING TEACHING LEARNING SELF REGULATION MEDICAL TRAINING MANAGING

PROFESSIONAL COMPETENCY INVENTORY

LEARNING TEACHING MANAGING LEADING PROFESSIONAL COMPETENCY PROFILE SELF REG 4 ADBCEFGHIJKLMN O 2.4

LEARNING / INTEGRATION INTEGRATION: Confident of abilities Aware of growth areas Open for developmental feedback Works hard DEVELOPMENTAL STRATEGIES Knowledge based reading How to receive feedback Time management

LEARNING / INTEGRATION INTEGRATION DEVELOPMENTAL STRATEGIES: Seek out feedback from peers and faculty in growth areas Utilize systems-based learning tools Track time efficiency Use PDA resources Utilize on-line learning modules

VALIDATION CORRELATE PCI TO: FITNESS REPORTS ROTATION EVALUATIONS

TEN PRACTICE GUIDELINES ENLIST A POWER BROKER USE EXISTING EB MODELS (EI) AS MODEL FOR CHANGE INTEGRATE PC LANGUAGE INTO PRACTICE- Self Assessment > 360

TEN PRACTICE GUIDELINES BALANCE CONSENSUS & CONSULTATION MATCH PC MODEL TO THE CULTURE LINK TOOL TO ACADEMIC/BUSINESS NEED AND IDENTITY ADOPT A DEVELOPMENTAL MODEL

TEN PRACTICE GUIDELINES FACDEV ”COACHING”- Meld EI and Health Behavior Change models- Develop dissonance INTEGRATE LONGITUDINALLY REINFORCE VISION ESPECIALLY WHEN THE “TRIBAL MEMBERS” CHANGE

RESOURCES Goleman, D (1995). Emotional intelligence Goleman (1998). Working with emotional intelligence. Goleman, Boyatzis, McKee (2002). Primal leadership: Realizing the power of emotional intelligence. Boyatzis,McKee (2006) Resonant Leadership Website- Consortium for Research on EI in Organizations

“BE THE CHANGE… YOU WISH TO SEE IN THE WORLD” M.K. GANDHI