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Systems Based Practice - References

Systems-Based Practice (SBP) is defined by ACGME as "an 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." 

References for SBM Core Competencies

 

Doezema D, McLaughlin S, Sklar DP. An approach to fulfilling the systems-based practice competency requirement. Acad Emerg Med. 2002 Nov; 9(11): 1355-9.

An Emergency Medicine Residency reports on the use of portfolio projects to educate and evaluate awareness of the community resources in the greater context of medical practice.

 

Dyne PL, Strauss RW, Rinnert S. Systems-based practice: the sixth core competency. Acad Emerg Med. 2002 Nov; 9(11): 1270-7.

A report from the RRC for Emergency Medicine identifies seven tasks (i.e. out of hospital care, prevention, team management), specific evaluative tools and curriculum components.

 

Johnston KC. Responding to the ACGME's competency requirements: an innovative instrument from the University of Virginia's neurology residency. Acad Med. 2003 Dec; 78(12): 1217-20.

A Neurology residency describes their assessment and evaluation instruments, called Self Assessment and Vital Evaluation (SAVE) designed to teach and evaluate the core competencies.

 

Legome E. Pancu D. Nadel E. Manko J. A novel approach to resident evaluation and the core competencies. Acad Emerg Med. 2003 Jan; 10(1): 97.

An Emergency Medicine Residency reports the use of Internet available a single page evaluation data collection form for the core competencies.

 

Lypson ML, Frohna JG, Gruppen LD, Woolliscroft JO. Assessing residents' competencies at baseline: identifying the gaps. Acad Med. 2004 Jun; 79(6): 564-70.

An Internal Medicine Residency reports on the use of an eight-station OSCE including a 20 MCQ test concerning safety equipment and JCAHO requirements.

 

Marcdante K, Gruppen L, Yoder E, Simpson D. Teaching and Assessing Systems-Based Practice: Integration Strategies. Presented at the Annual Meeting of the American Association of Medical Colleges, Washington DC. November 11, 2003.

The AAMC introduces the TACTICS (Teamwork, Advocacy, Coordination, Technology, Improvement, Cost-effectiveness, Safety) paradigm.

 

McLaughlin SA. Doezema D. Sklar DP. Human simulation in emergency medicine training: a model curriculum. Acad Emerg Med. 2002 Nov.; 9(11): 1310-8.

An Emergency Medicine Residency reports the use of simulation to evaluate the core competencies including interactions with consultants, administrators, and errors in triage, charting and medication.

 

Miller DC, Montie JE, Faerber GJ. Evaluating the Accreditation Council on Graduate Medical Education core clinical competencies: techniques and feasibility in a urology training program. J Urol. 2003 Oct; 170(4 Pt 1): 1312-7.

A Urology Residency reports on present and planned assessments for core competencies including the use of root cause analysis of an error, patient advocacy and use of consultations.

 

Mohr JJ, Randolph GD, Laughon MM, Schaff E. Integrating improvement competencies into residency education: a pilot project from a pediatric continuity clinic. Ambul Pediatr. 2003 May-Jun; 3(3): 131-6.

A Pediatric residency reports on the use of a multidisciplinary improvement team to incorporate systems-based practice in to the training and evaluative experience.


Sachdeva AK. Invited commentary: Educational interventions to address the core competencies in surgery. Surgery. 2004 Jan; 135(1): 43-7.

A report from the American College of Surgeons that includes plans to focus on patient safety for education and evaluation for system-based practice.

http://www.abderm.org/residency/table.htm

American Board of Dermatology - a grid for each competency with example components and general evaluation tools. Systems-Based Practice is divided into four areas: interaction of their practices with the larger system, delivery systems, cost-effective care and advocacy for patients.

http://www.apds.org/2003%20APDS%20Talks/7-%20System%20Based%20Practice5-09-03.ppt

Association of Program Directors in Surgery - A PowerPoint presentation including suggested observable activities and evaluation approaches for System-Based Practice

http://www.med.umn.edu/gme/Outcomes/Competency-Based_Template_Evalue.pdf

University of Minnesota, Medical School - A grid containing a grading scheme for each core competency. Systems-Based Practice contains four domains: delivery systems, cost-effectiveness, advocacy and team-building/partnering

http://www.umm.edu/imres/pdf/Comp-SystemsBasedPractice.pdf

University of Maryland, Internal Medicine Residency – Goals and objectives with general evaluation tools. Four broad areas are outlined as: Delivery systems, cost-effective health care/resource allocation, partner with health care managers /providers and reciprocal impacts

 

 

 
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