Writing Narratives Based on ACGME Competencies

Narratives What Are They?  Written Evaluation of Student Performance Formative  Mid-Course Evaluation Summative  End of Course Direct Observation of Learners Why?  Assessment of Student Performance in the Absence of Exams Correct Mistakes Reinforce Good Performance Provide a Framework for Professional Development  Permanent Record – CAPS

Narratives Are: Form of Feedback FAIR - Clearly Defined Expectations  Understood By Both Faculty & Student Constructive  Power = Positive  Positive Critique Goal-Oriented -Student Input Improve Individual & Group Dynamics Set Mutually Agreed Upon Goals Objectives Discuss Our Expectations for Student Performance: ACGME Competencies Discuss techniques for Providing Constructive Feedback Case-Based Learning

Competency-Based Curriculum If You Don’t Know Where You’re Going, You’ll Never Get There! Educational experiences Environment Assessments Standards

Developing Competence as a physician Practice-based Learning & Improvement Interpersonal & Communication Skills Patient Care Professional- ism Medical Knowledge Systems- Based Practice ACGME Competencies

Medical knowledgeEstablished and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and application of this knowledge to patient care Patient CareCompassionate, appropriate, and effective for the treatment of health problems and the promotion of health Practice-Based Learning & Improvement Investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvements in patient care Systems Based Improvement 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 Interpersonal &Communication Skills Effective information exchange and teaming with patients, their families, and other health professionals ProfessionalismCommitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population

Example – Clearly Defined Goals Practice-Based Learning and Improvement The competent graduate will be self aware and understand his/her learning needs to continually optimize their professional performance and patient care. The graduate should be able to investigate, reflect, and evaluate his/her patient- care practices and to critically filter, appraise and assimilate evolving scientific evidence.

Educational Program Objectives Facilitate the learning of students/others. Use information technology to manage/access information and support self-education. Locate, appraise, and assimilate evidence from scientific studies related to their patients’ health problems; apply knowledge of epidemiological principles and proper study design for the appraisal of clinical studies Obtain and use information about their population of patients and the larger population from which patients are drawn. Analyze clinical experiences and reflect on personal practice patterns to initiate practice-based improvement activities.

Facilitate the Learning of Students and Other Health Care Professionals. Knowledge/Skills/Attitudes/Objectives  Assess & address educational needs of other team members  Demonstrate commitment to mentoring  Engage others in bi-directional learning  Explore & employ principles of adult learning  Provide constructive feedback to students and peers and listen as they reciprocate

Student Narratives in CBL

CBL Evaluation Cycle Year-Long Course  No Exams Formative Evaluation – Fall  Student/Facilitator Meeting  Scoring System Based on Competencies  Written Narrative Summative Evaluation – Spring  Student/Facilitator Meeting  Scoring System Based on Competencies  Written Narrative

Good Feedback Timely Specific Constructive Good Listening Focused on the Positive Allows Student Input

Student/Facilitator Meeting: The Positive Critique Outline the Evaluation Process Ask: What Do You Think You Are Doing Well? Add: What You Think The Student Does Well Ask: What Would You like to Improve? Add: Other Things You Think Could Be Improved

How Do You Get to Know Your Students? Direct Observation - Take Notes Informal: Ask - What do you do well? What would you like to improve? Other????

Examples – Standardized Students Mandy Ginger Rudy Take 5!

Mandy Ginger Rudy Standardized Students

References Describes methods for giving students effective feedback TCMCs Doctor of Medicine Education Program Objectives, sent by Dr Wilcox on 11/29/ Part of series of articles. This one is on giving feedback and explains the positive critique method “Practical Implementation of the Competencies”: ©2006 ACGME. Includes descriptions of approaches that can be used for teaching residents – useful for constructing learning questions