PEDIATRIC COMPETENCIES

The Accreditation Council on Graduate Medical Education (ACGME) requires that all residents be assessed on 6 competencies

Patient Care. Provide family centered patient care that is developmentally and age appropriate, compassionate, and effective for the treatment of health problems and the promotion of health.

1.a. Gather essential and accurate information using the following clinical skills: medical interviewing, physical examination, diagnostic studies and developmental assessments.

1.b. Make informed diagnostic and therapeutic decisions based on patient information, current scientific evidence and clinical judgment, using clinical problem-solving skills, recognizing the limits of one's knowledge and expertise, gathering appropriate information and using colleagues and consultants appropriately.

1.c. Develop and carry out patient care plans, using principles of evidence-based decision-making, appropriate prioritization, and taking into account the needs, beliefs and resources of patient and family.

1.d. Effectively use common therapies within the scope of general pediatric practice, including a variety of prescription and non-prescription medications, intravenous fluids, inhalation treatments, as well as special diets and nutritional supplements. Be familiar with therapies commonly used by subspecialists and other professionals who care for children.

1.e. Prescribe and perform competently all medical procedures considered essential for the scope of general pediatric practice; be familiar with those procedures commonly used by subspecialists and other professionals who care for children.

1.f. Counsel patients and families in a supportive manner so they can understand their illness or injury and its treatment, share in decision-making, make informed consent and participate actively in the care plan.

1.g. Provide effective preventive health care and anticipatory guidance to patients and families.

Medical Knowledge. Understand the scope of established and evolving biomedical, clinical, epidemiological and social-behavioral knowledge needed by a pediatrician; demonstrate the ability to acquire, critically interpret and apply this knowledge in patient care.

2.a. Demonstrate that one knows or can efficiently access the knowledge base needed for effective patient care.

2.b. Critically evaluate current medical information and scientific evidence and modify one's knowledge base accordingly.

2.c. Recognize the limits of one's knowledge and expertise by seeking information needed to answer clinical questions and using consultants and referrals appropriately. Use this process to guide life-long learning plans.

2.d. Apply current medical information and scientific evidence effectively to patient care (e.g., use an open-minded, analytical approach, sound clinical judgment, and appropriate attention to priorities).

Communication Skills. Demonstrate interpersonal and communication skills that result in information exchange and partnering with patients, their families and professional associates.

3.a. Communicate effectively in a developmentally appropriate manner with patients and families to create and sustain a therapeutic relationship across the broad range of socioeconomic and cultural backgrounds.

3. b. Communicate effectively with physicians, other health professionals, and health related agencies to create and sustain information exchange and team work for patient care.

3. c. Develop effective approaches for teaching students, colleagues, other professionals and lay groups.

3. d. Work effectively as a member or a leader of a health care team, and collaborate productively with professional organizations.

3. e. Serve as a consultant on pediatric matters to other physicians and health professionals.

3.f. Maintain comprehensive, timely and legible medical records.

Practice-based Learning and Improvement. Demonstrate knowledge, skills and attitudes needed for continuous self-assessment, using scientific methods and evidence to investigate, evaluate, and improve one's patient care practice.

4.a. Use scientific methods and evidence to investigate, evaluate and improve one's own patient care practice; continually strive to integrate best evidence into daily practice.

4.b. Systematically assess the health care needs of one's practice population, and use this information to direct population-based problem-solving, with special attention to preventable morbidity and risk.

4.c. Demonstrate willingness and capability to be a life-long learner by pursuing answers to clinical questions, using literature, texts, information technology, patients, colleagues and formal teaching conferences.

4.d. Be prepared to alter one's practice of medicine over time in response to new discoveries and advances in epidemiology and clinical care.

4.e. Seek and incorporate feedback and self-assessment into a plan for professional growth and practice improvement (e.g., use evaluations provided by patients, peers, superiors and subordinates to improve patient care).

Professionalism. Demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to diversity.

5.a. Demonstrate commitment, responsibility, accountability for patient care, including continuity of care.

5.b. Be honest and use integrity in one's professional duties.

5.c. Consistently use compassion and empathy in one's role as a physician.

5.d. Maintain professional boundaries in one's dealings with patients, family, staff, and professional colleagues.

5.e. Place the needs of patients and society over one's own self-interest.

5.f. Demonstrate sensitivity and responsiveness to patients' and colleagues' gender, age, culture, disabilities, ethnicity, and sexual orientation.

5.g. Meet high standards of legal and ethical behavior.

5.h. Develop a healthy lifestyle, fostering behaviors that help balance personal goals and professional responsibilities. Recognize and respond to personal stress and fatigue that might interfere with professional duties.

Systems-Based Practice. Understand how to practice high quality health care and advocate for patients within the context of the health care system.

6.a. Know how types of medical practice and delivery systems differ from one another with respect to how they control health care costs, allocate resources, and assure quality.

6.b. Practice cost-effective health care and resource allocation that does not compromise quality of care.

6.c. Advocate for patients in one's practice, by helping them with systems complexities and identifying resources to meet their needs.

6.d. Work with health care managers and providers to assess, coordinate, and improve patient care, consistently advocating for high quality.

6.e. Advocate for the promotion of health and the prevention of disease and injury in populations.

6.f. Acknowledge medical errors and develop practice systems to prevent them.

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This list of specific skills within each competency category was developed by the project team for the APA Educational Guidelines for Pediatric Residency. Diane Kittredge, Constance Baldwin, Miriam Bar-on, Patricia Beach, and Franklin Trimm (Eds.). Ambulatory Pediatric Association website, www.ambpeds.org/EGweb/index.cfm [Accessed 11/06/03] . supported by the Josiah Macy, Jr., Foundation 2002-2004