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C.S. Mott Children's Hospital

Competency-Based Education

Resident progress towards becoming competent pediatricians is achieved through compliance with all requirements of the Pediatrics Residency Review Committee (RRC), through ongoing, thoughtful assessment of the “six general competencies,” and through careful monitoring by the pediatric tracking program of the American Board of Pediatrics.  The emphasis is on steady achievement and demonstration of both general and specific competencies over the three years of pediatric training.  Our evaluation system is comprehensive, robust, and multidimensional, and it provides residents with extensive ongoing feedback about their individual performance.  Residents are evaluated monthly by the supervising faculty members and senior residents; there is also a system for evaluations by patients, nurses, and peers to add additional perspectives on resident performance.  In addition, assessment of specific competencies occurs during individual rotations and is tracked longitudinally.

We attempt to make documentation of procedures and competencies as easy possible through the use of online systems, staff assistance, and regular review.  Each year, residents take the In-Training Exam of the American Board of Pediatrics.  Feedback is given to residents regarding their performance and counseling /assistance is provided to ensure that residents are prepared to pass the Board Examination at the conclusion of training.  The program directors broadly review each resident’s progress on a quarterly basis and meet with each resident every six months to summarize their performance, to discuss career planning, and to elicit residents’ feedback on the program.

Increasingly, The Program is using cutting-edge human patient simulators to facilitate hands-on learning.  We have an award-winning “mock code” program that not only addresses the technical aspects of patient care emergencies, but also encompasses interpersonal communication and leadership skills as well.  Standardized patients are part of our curriculum in advanced communication skills. Our program has developed an extensive curriculum in advanced communication skills which complements and reinforces our focus on collaborative decision-making and patient-centered care. The curriculum includes specific training in breaking bad news, informed consent, using an interpreter, difficult communications, conflict management, building effective teams, and tools for incorporating patients' and families' health belief framework - including spirituality. Multiple teaching venues include conferences, panels, workshops, and web-based cases. Standardized patients are also used in this curriculum.

The Department of Pediatrics values practice-based learning.  Throughout residency, our program offers didactic training and clinical opportunities and extensive resources, all designed to assist residents in learning to practice more effectively in the changing health care environment.  The Health System provides 24-hour free access to Up-to-Date, MDConsult, Micromedix, Medline, as well as to more than 40 online texts and more than 6,000 online full-text journals, from any hospital computer.  This access facilitates an evidence-based approach to patient care and learning.  A medical librarian participates actively in our formal EBM curriculum and is available to assist residents in the preparation of presentations or to help answer clinical questions.

Resident involvement in research is encouraged and fostered; all residents participate in a scholarly activity during residency.  This scholarly activity may be an original research project, participation in an ongoing research effort, a case report, a quality improvement project, an advocacy project or an extended evidence-based literature review, among others.  Residents who are interested in original research meet one-on-one with a member of the Resident Research Committee to discuss research opportunities within the Department and to facilitate connection with a research mentor.  In addition to basic science research, there are opportunities to do clinical research, health services research, patient safety projects, or educational research.  All residents will also participate in a quality improvement project during residency. Most will do this by joning one of several collaborative patient care teams supported by an innovations grant to improve patient centered care.

Submission of manuscripts or abstracts resulting from research work done during residency is encouraged and there is financial support for travel to present original research at national meetings.  Our department also supports attendance of resident representatives to the American Academy of Pediatrics, and we are frequently able to support resident travel to attend meetings of other organizations such as the Pediatric Academic Societies, the National Medical Society, or the Student National Medical Association.