EDUCATIONAL PROGRAMS EVALUATION OF COMPETENCIES

The Neurology Residency Program has integrated the six neurology competencies into our curriculum, as stipulated by the ACGME. The AECOM Committee on Graduate Medical Education (COGME) has established the following policies pertaining to evaluation of residents:

1. Each residency program sponsored by the Albert Einstein College of Medicine must assess resident performance and use the results to improve resident performance.
2. Programs must develop methods to assure resident competence as in the following areas of performance:
   
   • Patient Care - The residency program must ensure that its residents, by the time they graduate, provide appropriate, effective, and compassionate clinical care.
   • Medical Knowledge - The residency program must ensure that its residents, by the time they graduate, possess knowledge in established and evolving biomedical, clinical and cognate sciences domains and the ability to apply it to clinical care.
   • Practice-Based Learning and Improvement - The residency program must ensure that is residents, by the time they graduate, are able to investigate, evaluate, and improve their patient care practices, using evidence from the scientific literature.
   • Interpersonal Skills and Communication - The residency program must ensure that its residents, by the time they graduate, can develop appropriate interpersonal relationships and communicate effectively with patients, their patients families, and professional associates.
   • Professionalism - The residency program must ensure that its residents, by the time they graduate, demonstrate the a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.
   • Systems-Based Practice - The residency program must ensure that its residents, by the time they graduate, are aware that health care is provided in the context of a larger system and can effectively call on system resources to support the care of patients.

Implementation of Core Competency Teaching into the Curriculum:

Patient Care and Medical Knowledge continue to be the focus of the large number of weekly clinical conferences taking place at both campuses. Our monthly journal club focuses on Practice Based Learning and Improvement teaching, while a weekly oral board review conference addresses both Practice Based Learning and Improvement and Interpersonal and Communication Skills. Conferences which include Professionalism teaching include the monthly ethics conference alternating with the monthly end of life care conference. Systems Based Practice is addressed in a monthly quality assurance conference. We continue to distribute the AAN Clinical Practice Guidelines to all residents, which further addresses Practice Based Learning and Improvement.

Evaluation of the Core Competencies:

The system by which neurology resident performance is evaluated for each of the six competency areas is outlined below. The system relies on four core approaches:

1. Comprehensive evaluation system including 360 Degree evaluations and focused direct observation.
2. Residency portfolios
3. Objective measures of performance ie. RITE examination
4. Observed neurology examinations (NEX)

Resident portfolios, including procedure logs

Residents maintain detailed residency portfolios. Elements which are collected online include procedure logs and work hour logs on myevaluations.com. A specific number of certain procedures will be required to ascertain competency in those procedures, though the number will vary from procedure to procedure. Progress is monitored during the semi-annual evaluation meetings with the Program Director. Documents concurrently maintained by the residency administration include national and local conference attendance, journal club presentation, and other presentations. These results are utilized to track resident progression and maturation, and evaluate the effectiveness of the program.

Items included in the portfolio are:

1. Documentation of hospital-required training materials addressing risk management, privacy and other courses;
2. Attendance at conferences and didactic activities;
3. Neurological procedure logs
   1. Lumbar puncture
   2. Brain Death Assessment/Caloric testing
   3. Apnea testing
4. Medical errors or complications of therapy
5. Teaching activities (include copy of any handouts or slides)
   1. Medical student lectures
   2. Board Review Course
   3. Others
6. Presentations given (include copy of any handouts or slides)
   1. Case conference presentations
   2. Q/A Morbidity and mortality conference
   3. Journal club
   4. Ethics/End of Life lectures
   5. Public education lectures
   6. Other
7. RITE scores
8. Departmental or hospital administrative activities (include schedule of activities)
   1. Organizational or leadership roles
   2. Committee participation
9. Formal coursework
   1. Columbia Neuroscience course
   2. Office of Clinical Trials Research Course
   3. Others
10. Major NYC/National/International Meetings (include schedule of specific activities attended)
11. Research activities
    1. Abstracts
    2. Manuscripts
    3. Research mentorship program
    4. IRB proposals

Residency In Service Training Examination

Residents are required to take the annual In Service Examination. The results are reviewed during the semi-annual evaluation meetings with the program director. Areas of specific strength and weakness are discussed, and a comparison of both overall and specific topic performance from prior years is incorporated in the discussion, in order to track self-improvement. The results are further utilized to evaluate the curriculum and direct changes to the educational program.