minimally invasive gynecology milestones these milestones ... · level 2: the fellow is advancing...

MinimallyInvasiveGynecologyMilestones

ThesemilestoneshavebeendevelopedtoevaluatetheongoingprogressoftraineesintheFellowshipinMinimallyInvasiveGynecology.Themilestonesaimtoprovideaframeworkforassessmentoftheessentialskillsandknowledgeexpectedofa

participantgraduatingfromthefellowshipandaidintheidentificationofanysurgicaloreducationaldeficiencieswithampletimeforremediation.Thesemilestonesarenotdesignedtocoverallaspectsofbenigngynecologicsurgery,butrathertohelpensurethatfellowsgraduatingfromeachprogramwillachievecompetencywithkeysurgicalandclinicalskills.TheseMilestonesarenot

designedtoberelevantinanyothercontext.

Committee/WorkingGroupJubileeBrown

AnneMarieConnolyNoahRindosMandyYunker

Milestonereporting

Themilestonesareintendedtobeusedbyfellowshipprogramstoaidwithsemi-annualfellowreviewsandwithreportingtoAAGL.Milestonesareknowledge,skills,attitudes,andotherattributesorganizedinadevelopmentalframeworkfromlesstomoreadvanced.Theyaredescriptorsandtargetsforfellowperformanceasafellowmovesfromentryintofellowshipthroughgraduation.Theattributesmeasuredincludegynecologicknowledge,surgicalskills,providerattitude,andadditionalattributesexpectedoffellowspursuingadvancedtraininginMinimallyInvasiveGynecology.Foreachperiod,reviewandreportingwillinvolveselectingmilestonelevelsthatbestdescribeafellow’scurrentperformanceandattributes.Milestonesarearrangedintonumberedlevels.TrackingfromLevel1toLevel4issynonymouswithmovingfromnovicetoexpertinthesubspecialty.Eachmilestoneiscomprisedoffourlevels,rangingfromnovicetoadvancedindependentpractitioner.Thesemilestoneswillcompriseonepartoftheaccreditationprocessforeachprogram,andaportionoftheevaluationforgraduationforeachfellow.Overeachsixmonthperiod,milestoneswillberecordedanddiscussedwiththefellowstoevaluatetheirsurgicalperformanceandattributes.Allfellowswillbeexpectedtoattainalevelof2inthemajorityofmilestonesbytheendoftheirfirstyearanda3bythetimetheyarepreparingtograduate.Selectionofalevelimpliesthatthefellowsubstantiallydemonstratesthemilestonesinthatlevel,aswellasthoseinlowerlevels,asfollows:Level1:Thefellowdemonstratesmilestonesexpectedofanincomingfellow/recentlygraduatedOBGYNresidentLevel2:Thefellowisadvancingandisperformingatmid-fellowshiplevelLevel3:Thefellowhasadvancedandismeetingthemajorityofmilestonestargetedforfellowship.(Leveldesignatedasgraduationtarget.)Level4:Thefellowhasadvancedbeyondperformancetargets,isabletofunctionmostlyindependently,andisdemonstrating“aspirational”goalsconsistentwithsomeoneinpracticeforseveralyears.

Milestones

PC1:SurgicalCareofBenignGynecologicConditions—OpentechniquesLevel1 Level2 Level3 Level4IndependentlyselectsappropriateopenproceduresforbenigngynecologicconditionsProficientlyandsafelyperformsbenignstraightforwardgynecologicopenproceduresIdentifiessurgicalcomplicationsandappropriatelyusesintra-operativeconsultation

Effectivelyassistsincomplexopengynecologicprocedures(i.e.largeuterus,frozenpelvis)Recognizesanddevelopsmanagementstrategyforintra-operativecomplications,includingconversiontoanopenprocedure

Effectivelyperformscomplexopengynecologicprocedures,withsupervisionManagessurgicalcomplications,withsupervisionCollaborateswithandprovidessubspecialty-specificopensurgicalconsultationtoothermembersofthehealthcareteam,includingconversiontoanopenapproach,withsupervision

IndependentlyandproficientlyperformscomplexopengynecologicproceduresAnticipates,diagnoses,andindependentlymanagesintra-operativesurgicalcomplications,includingthedecisiontoconverttoanopenapproachIndependentlycollaborateswithandprovidessubspecialty-specificopensurgicalconsultationtoothermembersofthehealthcareteamAbletoinstructresidentsinpropersurgicaltechniqueswithminimalguidance

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

PC2:SurgicalcareofBenignGynecologicConditions:MinimallyInvasiveTechniques-Laparoscopyand/orRoboticPlatformLevel1 Level2 Level3 Level4IndependentlyselectsappropriateminimallyinvasivesurgicalproceduresforbenigngynecologicconditionsProficientlyandsafelyperformsbasicminimallyinvasiveprocedures(i.e.tubalsterilization,adnexectomy,hysterectomy,diagnosticlaparoscopy)IdentifiesMIS-specificcomplicationsandappropriatelyusesintra-operativeconsultation

ProposesappropriateMISproceduresforcomplexbenigngynecologicconditionsEffectivelyassistsduringcomplexMISproceduresRecognizesanddevelopsmanagementstrategiesforMIS-relatedintraoperativecomplications

EffectivelyperformscomplexMISgynecologicprocedures,withsupervisionManagesMIS-relatedsurgicalcomplications,withsupervisionCollaborateswithandprovidessubspecialty-specificMISconsultationtoothermembersofthehealthcareteam,withsupervision

IndependentlyandproficientlyperformscomplexMISgynecologicproceduresAnticipates,diagnoses,andindependentlymanagesintra-operativeMIS-relatedcomplicationsIndependentlycollaborateswithandprovidessubspecialty-specificMISsurgicalconsultationtoothermembersofthehealthcareteamAppliesanevidence-basedapproachtoinnovativeandcomplexMIStreatmentplansforbenigngynecologicconditionsAbletoinstructresidentsinpropersurgicaltechniqueswithminimalguidance

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

PC3:SurgicalcareofBenignGynecologicConditions:MinimallyInvasiveTechniques-VaginalApproachLevel1 Level2 Level3 Level4IndependentlyconsidersvaginalsurgicalapproachwhenappropriateforbenigngynecologicconditionsUnderstandsstepsofvaginalhysterectomyandperformsstraightforwardproceduresindependentlyIdentifiescomplicationsofvaginalhysterectomyandappropriatelyusesintra-operativeconsultation

ProficientlyandsafelyperformsstraightforwardvaginalhysterectomyEffectivelyassistsduringcomplexvaginalproceduresRecognizesanddevelopsmanagementstrategiesforintraoperativecomplicationsofvaginalsurgery

Effectivelyperformscomplexvaginalprocedures,withsupervisionManagescomplicationsofvaginalsurgery,withsupervisionCollaborateswithandprovidessubspecialty-specificconsultationtoothermembersofthehealthcareteam,withsupervision

IndependentlyandproficientlyperformscomplexvaginalproceduresAnticipates,diagnoses,andindependentlymanagesintra-operativecomplicationsrelatedtovaginalsurgeryIndependentlycollaborateswithandprovidessubspecialty-specificsurgicalconsultationtoothermembersofthehealthcareteamAppliesanevidence-basedapproachtoinnovativeandcomplextreatmentplansforbenigngynecologicconditionssurroundingvaginalsurgeryAbletoinstructresidentsinpropersurgicaltechniqueswithminimalguidance

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

PC4:SurgicalcareofBenignGynecologicConditions:MinimallyInvasiveTechniques-HysteroscopyLevel1 Level2 Level3 Level4IndependentlyconsidershysteroscopicapproachwhenappropriateforbenigngynecologicconditionsUnderstandsstepsofhysteroscopicsurgeryandresectionandperformsstraightforwardproceduresindependentlyIdentifiescomplicationsofhysteroscopyandoutlinesmanagementstrategies

ProficientlyandsafelyperformsstraightforwardhysteroscopicresectionsRecognizesanddevelopsmanagementstrategiesforintraoperativecomplicationsofhysteroscopy

Effectivelyperformscomplexhysteroscopicprocedures,withsupervisionManagescomplicationsofhysteroscopy,withsupervisionCollaborateswithandprovidessubspecialty-specificconsultationtoothermembersofthehealthcareteam,withsupervision

IndependentlyandproficientlyperformscomplexhysteroscopicproceduresAnticipates,diagnoses,andindependentlymanagesintra-operativecomplicationsrelatedtohysteroscopyIndependentlycollaborateswithandprovidessubspecialty-specificsurgicalconsultationtoothermembersofthehealthcareteamAppliesanevidence-basedapproachtoinnovativeandcomplextreatmentplansforbenigngynecologicconditionssurroundinghysteroscopicsurgeryAbletoinstructresidentsinpropersurgicaltechniqueswithminimalguidance

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

PC5:MedicalManagementofAbnormalUterineBleedingLevel1 Level2 Level3 Level4Demonstratesin-depthknowledgeofthephysiologyofthenormalmenstrualcycleDemonstratesabilitytoformulateadifferentialdiagnosisandperforminitialevaluationandtreatmentplanforpatientspresentingwithabnormaluterinebleedingDemonstratetheabilitytoutilizefocuseddiagnosticapproaches

Demonstratesanin-depthknowledgeregardingpatientspresentingwithtypicalabnormaluterinebleedingrelevanttovaryingpatternsofpresentation,comprehensivetreatmentoptions,andrefractorybleedingManagespatientswithcomplexandatypicalabnormaluterinebleedingwithacomprehensivemanagementplan,withsupervisionDemonstratestheabilitytoformulatecomprehensiveplansofmanagementforpatientswithmultipleand/orcomplexcomorbidities

IndependentlymanagespatientswithcomplexandatypicalabnormaluterinebleedingCollaboratesandprovidesconsultationtoothermembersofthehealthcareteamregardingabnormaluterinebleedingLeadsamultidisciplinaryteamforcareofpatientswithacuteandchronicabnormaluterinebleeding

Appliesinnovativeapproachestocomplexandatypicalabnormaluterinebleedingandimplementstreatmentplansbasedonemergingevidence

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

PC6:PerioperativeCare,includingSurgeryonSpecialPopulationsLevel1 Level2 Level3 Level4AssessespreoperativesurgicalriskandproposesamanagementplantooptimizesurgicaloutcomesinbenigngynecologicpatientsAnticipates,diagnoses,andmanagesmedicaldisordersandsurgicalcomplicationsinbenigngynecologicpatientsduringthepostoperativeperiod

Identifiesspecialpatientpopulationswhichrequiresupplementalpreoperativeassessmentandindividualizedmanagementstrategies,accordingtotheirspecificpresentationordisease-state(i.e.obesity,BRCA+status,adolescents)RecognizesmedicaldisordersandsurgicalcomplicationsinpatientswithcomplexbenigngynecologicconditionsProposesmanagementstrategiesformedicaldisordersandsurgicalcomplicationsinpatientswithcomplexbenigngynecologicconditions

Implementsaplantooptimizesurgicaloutcomesinspecialpatientpopulationswithcomplexbenigngynecologicconditions,withsupervisionParticipatesincriticalcaremanagementofgynecologicsurgicalpatientswithcomplexmedicaldisorders,withsupervisionCollaborateswithandprovidessubspecialty-specificconsultationtoothermembersoftheperi-operativehealthcareteam,withsupervision

Independentlyassessespre-operativesurgicalriskanddevelopsaplantooptimizesurgicaloutcomeinspecialpatientpopulationswithcomplexbenigngynecologicconditionsIndependentlycollaborateswithandprovidessubspecialty-specificconsultationtoothermembersoftheperi-operativehealthcareteam,includingcriticalcarespecialistsAppliesanevidence-basedapproachtoinnovativeperi-operativemanagementofsurgicallycomplexpatients

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

PC7:ManagementofLeiomyomataLevel1 Level2 Level3 Level4Demonstratetheabilitytoperforminitialevaluation,formulateafocuseddifferentialdiagnosis,andutilizefocuseddiagnosticapproachesforleiomyomataFormulateacomprehensivemanagementplan,withassistance

Demonstrateanin-depthknowledgeregardingevaluation,workup,andcounselingofpatientswithleiomyomataDemonstratestheabilitytoformulatecomprehensivemanagementplansforpatientsbasedonage,anatomiclocation,symptoms,andreproductivedesires

CollaboratesandprovidesconsultationtoothermembersofthehealthcareteamregardingleiomyomataIndependentlyimplementscomprehensivemanagementplansforpatientswithleiomyomata,includingsurgicalandmedicalmanagementoptions

IndependentlyandproficientlyperformscomplexproceduresonleiomyomataAnticipates,diagnoses,andindependentlymanagesintra-operativeanatomicchallengesandcomplicationsrelatedtoleiomyomataIndependentlycollaborateswithandprovidessubspecialty-specificsurgicalconsultationtoothermembersofthehealthcareteamAppliesinnovativeapproachestoleiomyomataandimplementstreatmentplansbasedonemergingevidence

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

PC8:ManagementofEndometriosisLevel1 Level2 Level3 Level4Demonstratetheabilitytoperforminitialevaluation,formulateafocuseddifferentialdiagnosis,andutilizefocuseddiagnosticapproachesforendometriosisFormulateacomprehensivemanagementplan,withassistance

Demonstrateanin-depthknowledgeregardingevaluation,workup,andcounselingofpatientswithendometriosisDemonstratestheabilitytoformulatecomprehensivemanagementplansforpatientsbasedonage,anatomiclocation,symptoms,andreproductivedesires

CollaboratesandprovidesconsultationtoothermembersofthehealthcareteamregardingendometriosisIndependentlyimplementscomprehensivemanagementplansforpatientswithendometriosis,includingsurgicalandmedicalmanagementoptionsConsultsotherservicesappropriatelyforendometriosisrelatedsurgicalissues

IndependentlyandproficientlyperformscomplexproceduresforendometriosisAnticipates,diagnoses,andindependentlymanagesintra-operativeanatomicchallengesandcomplicationsrelatedtoendometriosisIndependentlycollaborateswithandprovidessubspecialty-specificsurgicalconsultationtoothermembersofthehealthcareteamAppliesinnovativeapproachestoleiomyomataandimplementstreatmentplansbasedonemergingevidence

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

PC9:ManagementofAdnexalPathology/PelvicMassLevel1 Level2 Level3 Level4Demonstratetheabilitytoperforminitialevaluation,formulateafocuseddifferentialdiagnosis,andutilizefocuseddiagnosticapproachesforpelvicmassFormulateacomprehensivemanagementplan,withassistance

Demonstrateanin-depthknowledgeregardingevaluation,workup,andcounselingofpatientspresentingwithapelvicmassrelevanttovaryingpatternsofpresentationandcomprehensivetreatmentoptionsDemonstratetheabilitytoformulatecomprehensivemanagementplansforpatientsbasedonage,anatomiclocation,symptoms,andreproductivedesiresDeterminetheneedforconsultation,referral,ortransferofpatientsDemonstratestheabilitytoformulatecomprehensivemanagementplansforpatientswithmultipleand/orcomplexcomorbidities

CollaboratesandprovidesconsultationtoothermembersofthehealthcareteamregardingpelvicmassIndependentlyimplementscomprehensivemanagementplansforpatientswithadnexalpathology,includingsurgicalandmedicalmanagementoptionsConsultsotherservicesappropriatelyforsurgicalissuesrelatedtoadnexalpathology

Appliesinnovativeapproachestocomplexandatypicalpelvicmassandimplementstreatmentplansbasedonemergingevidence

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

PC10:ManagementofPelvicPainLevel1 Level2 Level3 Level4DemonstratesabilitytoformulateadifferentialdiagnosisandperforminitialevaluationandtreatmentplanforpatientspresentingwithacuteorchronicpelvicpainDemonstratetheabilitytoutilizefocuseddiagnosticapproaches

Demonstrateanin-depthknowledgeregardingpatientspresentingwithacuteorchronicpelvicpainrelevanttovaryingpatternsofpresentation,treatmentoptions,andrefractorypelvicpainManagespatientswithcomplexandatypicalacuteandchronicpelvicpainwithacomprehensivemanagementplan,withsupervisionDemonstratestheabilitytoformulatecomprehensiveplansofmanagementforpatientswithmultipleand/orcomplexcomorbidities

IndependentlymanagespatientswithcomplexandatypicalacuteandchronicpelvicpainLeadsamultidisciplinaryteamforcareofpatientswithacuteorchronicpelvicpain

Appliesinnovativeapproachestocomplexandatypicalacuteandchronicpelvicpainandimplementstreatmentplansbasedonemergingevidence

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

MK1(Anatomy)Level1 Level2 Level3 Level4Demonstratesknowledgeofbasicpelvicanatomytoincludemajororgansincludingneurovascularandmusculoskeletalstructures

Demonstratesknowledgeofthevascularandnervesupplytoeachofthepelvicorgansandstructures,includingtheexternalgenitalia,uterus,adnexa,ureter,bladder,andrecto-sigmoidcolonDemonstratesknowledgeofnormalretroperitonealanatomy

AppliesknowledgeofnormalpelvicandabdominalanatomyinthesurgicalsettingDemonstratesknowledgeofpelvic,retroperitoneal,andupperabdominalanatomydistortedbybenigngynecologicconditions(i.e.endometriosis,fibroids,adnexalmass,adhesions,mülleriananomalies)

Appliesknowledgeofpelvic,retroperitoneal,andupperabdominalanatomydistortedbybenigngynecologicconditionsinacomplexsurgicalsettingAppliesknowledgeofanatomywhenreviewingdiagnosticstudies

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

MK2:MenstrualCyclePhysiologyandManagementofHormonalInterventionLevel1 Level2 Level3 Level4Understandsbasicreproductivephysiologyanddescribeshormonalchangesundernormalphysiologicconditions

EffectivelyassistsindiagnosingirregularitiesinmenstrualfunctionRecognizesanddevelopsmanagementstrategyforirregularitiesrelatedtomenstrualdysfunction,includingabnormaluterinebleeding,post-menopausalhormonaltherapy,andendometriosis

EffectivelydevelopstreatmentplansforirregularitiesrelatedtomenstrualdysfunctionManagesirregularitiesrelatedtomenstrualdysfunction,includingabnormaluterinebleeding,post-menopausalhormonaltherapy,andendometriosis,withsupervisionCollaborateswithandprovidessubspecialty-specificconsultationtoothermembersofthehealthcareteam,whenappropriate

IndependentlyandproficientlyperformsmedicaldecisionmakingrelatedtomenstrualdysfunctionAnticipates,diagnoses,andindependentlymanagescomplexmedicalsituationsrelatedtomenstrualdysfunction,includingabnormaluterinebleeding,hormonaltherapy,andendometriosis,whennotrespondingtofirst-lineinterventionIndependentlycollaborateswithandprovidessubspecialty-specificconsultationtoothermembersofthehealthcareteam

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

MK3:DiagnosticTechniquesandTreatmentPlanningLevel1 Level2 Level3 Level4Demonstratesknowledgeofbasicimagingmodalitiesusedtoevaluatepatientswithbenigngynecologicconditions(e.g.ultrasound,HSG,MRI)Demonstratesknowledgeofbasicdiagnostictechniquesusedtoevaluatepatientswithbenigngynecologicconditions(e.g.endometrialbiopsy,colposcopy)

Appliesknowledgeofimagingmodalitiesanddiagnostictechniquestoplanappropriatesurgicalormedicalinterventionforbenigngynecologicconditions

Collaborateswithradiologistorotherspecialiststodeterminewhichimagingmodalitiesordiagnostictechniqueswouldbemosthelpfulindiagnosisandmanagementplan

Appliesknowledgeofdiagnostictechniquestoformulatetreatmentplansinthemostcomplexsettingandadjuststreatmentplansaccordinglyforpatientswithabnormalresults

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

MK4:CongenitalAnomaliesLevel1 Level2 Level3 Level4Demonstratesknowledgeofbasicimagingmodalitiesusedtoevaluatepatientswithcongenitalanomalies(e.g.ultrasound,HSG,MRI)Demonstratesknowledgeofbasicdiagnostictechniquesusedtoevaluatepatientswithcongenitalanomalies

Appliesknowledgeofimagingmodalitiesanddiagnostictechniquestoplanappropriatesurgicalormedicalinterventionforcongenitalanomalies

Collaborateswithradiologistorotherspecialiststodeterminewhichimagingmodalitiesordiagnostictechniqueswouldbemosthelpfulindiagnosisandmanagementplan

Appliesknowledgeofpelvic,retroperitoneal,andupperabdominalanatomyinspecificcongenitalanomaliestoformulatecomprehensivepatientspecifictreatmentplansImplementsknowledgeofcongenitalanomalies,resultsofevaluation,andpatientfactorstoformulatecomplexcomprehensivetreatmentplansforpatientswithcongenitalanomaliesandutilizesthisinformationinmodifyingthesurgicalapproach

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

MK5:PelvicFloorDisordersLevel1 Level2 Level3 Level4Demonstratesthemedicalknowledgesurroundingpelvicfloordisordersinthediagnosis,evaluation,andcounselingofthesepatientsPerformssystematicevaluationofthepelvicfloorandordersappropriatetestingwithsupervisionFormulateacomprehensivemanagementplan,withassistance

AppliesknowledgeofpelvicfloordisorderstocounselpatientsregardingmedicalandsurgicaloptionsfortherapyFormulatesacomprehensivetreatmentplanforpatientswithpelvicfloordisorders

Collaborateswithotherspecialiststodeterminewhichtherapeuticmodalitiesordiagnostictechniqueswouldbemosthelpfulindiagnosisandmanagementplansofpatientswithcomplexpelvicfloordisorders

Appliesknowledgeofpelvicfloordisordersinacomplexsetting

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

SBP1:ComputerSystemsLevel1 Level2 Level3 Level4Retrievesbasicpatientinformationfromtheelectronicmedicalrecord(EMR)

RetrievescomplexpatientinformationfromtheEMR

Generatesorders,communicateswithreferringphysiciansandtrainees,anddocumentscommunicationwithpatients

UsesEMRtoitsfullpotential,andfacilitatesintegrationofcomputer-basedcommunicationwithteam

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐ SBP2:Value-basedPatientCare(Quality/Cost)Level1 Level2 Level3 Level4Demonstratesknowledgeofgeneralobstetricsandgynecologyguideline-basedcare(e.g.,AmericanCollegeofObstetriciansandGynecologists[ACOG]publications)Demonstratesknowledgeoftheimportanceofprovidingcost-effectivecareUnderstandsthediversityandrolesofallmembersofthehealthcareteam

Demonstratesknowledgeofguideline-basedcarespecifictominimallyinvasivegynecologyDemonstratesknowledgeofcostrelatedtodiagnosticandtreatmentplansDemonstratesknowledgeofpersonnelandresourcesneededtofacilitatevalue-based(highquality,cost-effective)care

Appliesknowledgeofguideline-basedcarespecifictominimallyinvasivegynecology,withsupervisionIncorporatescost-awarenessintothedevelopmentofdiagnosticandtreatmentplans,withsupervision(e.g.,formularydrugs,genericdrugs,tailoringofdiagnostictests)Coordinatespersonnelandresourcestofacilitatevalue-basedcare,withsupervision

Independentlyappliesknowledgeofguideline-basedcarespecifictominimallyinvasivegynecologyIndependentlyincorporatescost-awarenessintothedevelopmentofdiagnosticandtreatmentplansIndependentlycoordinatespersonnelandresourcestofacilitatevalue-basedcare

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

PBLI1:ScholarlyactivityLevel1 Level2 Level3 Level4Criticallyreviewsandinterpretspublicationswiththeabilitytoidentifyhypotheses,studyaims,design,results,andlimitationsDemonstratesknowledgeofcommonlyusedstudydesigns(e.g.,randomizedcontrolledtrial[RCT],cohort,case-control)Demonstratesknowledgeofbasicprinciplesunderlyingtheethicalconductofresearchandtheprotectionofhumansubjects

Designsahypothesis-drivenorhypothesis-generatingscholarlythesis,underthedirectionofaresearchmentorDemonstratesknowledgeofadvancedstudydesignsandstatisticalmethodologyAppliestheprinciplesofethicsandgoodclinicalpracticetotheprotectionofhumansubjectsrecruitedtoparticipateinresearch,asindicated

Executesahypothesis-drivenorhypothesis-generatingscholarlythesis,underthedirectionofaresearchmentorAppliesknowledgeofadvancedstudydesignandstatisticalmethodologytoresearch,includingascholarlythesisComplieswithresearchoversightregulations

Completesanddefendsacomprehensivewrittenscholarlythesisthatdemonstrates:-advancedresearchmethodologyanddesign-statisticalanalysis-synthesisofscientificliterature,hypothesistesting,anddescriptionsoffindingsandresults

Comments:Notyetachievedlevel1:☐ PBLI2:Qualityimprovement(QI)Level1 Level2 Level3 Level4Identifiesproblemsinhealthcaredelivery

BeginsworkingonaQIproject,eitherasanindividualorasateammember

ContinuestodevelopaQIproject,employingmethodstomeasureandanalyzethedata

CompletesaQIproject,eitherasanindividualorteammemberDisplayseffectiveteamworkskills

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

PROF1:ProfessionalethicsandaccountabilityLevel1 Level2 Level3 Level4Demonstratesintegrity,respect,honesty,andcompassionIshonestandtruthfulinallcircumstancesUnderstandsHIPAApoliciesandappropriateuseconceptsDemonstratestimelinessincompletionofassignedrotations,reports,statelicensure,andduties

Isaccountableincompletionofduties,records,andpatientcareIssensitiveandresponsivetodiversepatientpopulationandneeds,regardlessofgender,age,race,sexualorientation,religion,ordisabilitiesDemonstratesknowledgeofregulationsforbillingandcoding

Acknowledgeserrorswithprogramdirector,facultymembers,and/orpatientsRespondswelltoconstructivecriticismTakesonresponsibilityrelatedtolearning,coordinationofcare,patientcare,ContinuousQualityImprovement(CQI),andcomplianceissues

Servesasarolemodelforhonesty,integrity,professionalism,andcompassionatepatientcareDemonstratescommitmenttoself-improvementPrioritizesandadvocatesforpatientneedsoverself-interestOperatesprofessionallyandindependentlyinvariouseducationalandpatientcareenvironments

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

PROF2:Compassion,Integrity,andRespectforOthersLevel1 Level2 Level3 Level4Understandstheimportanceofcompassion,integrity,andrespectforothersDemonstratessensitivityandresponsivenesstopatients

Consistentlyshowscompassion,integrity,andrespectintypicalsituationswithpatients,peers,andmembersofthehealthcareteamConsistentlydemonstratessensitivityandresponsivenesstodiversityofpatients’ages,cultures,races,religions,abilities,orsexualorientationsAcceptsconstructivefeedbacktoimprovehisorherabilitytodemonstratecompassion,integrity,andrespectforothers

Consistentlyshowscompassion,integrity,andrespectforpatientswhodeclinemedicaladvice,requestun-indicatedtestsortreatments,orhavepsychiatriccomorbidities,andforteammembersexperiencingconflictorhighstressModifieshisorherownbehaviorbasedonfeedbacktoimprovehisorherabilitytodemonstratecompassion,integrity,andrespectforothers

Consistentlymodelscompassion,integrity,andrespectforothersCoachesotherstoimprovecompassion,integrity,andrespectforpatients

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

ICS1:TeamworkandCommunicationwithPhysiciansandOtherHealthProfessionalsLevel1 Level2 Level3 Level4Understandstheimportanceofrelationshipdevelopment,informationgatheringandsharing,andteamwork

Demonstratesanunderstandingoftherolesofhealthcareteammembers,andcommunicateseffectivelywithintheteamDemonstratesanunderstandingoftransitionsofcareandteamdebriefing

WorkseffectivelyininterprofessionalandinterdisciplinaryhealthcareteamsParticipatesineffectivetransitionsofcareandteamdebriefingCommunicateseffectivelywithphysiciansandotherhealthcareprofessionalsregardingpatientcare

LeadsinterprofessionalandinterdisciplinaryhealthcareteamstoachieveoptimaloutcomesLeadseffectivetransitionsofcareandteamdebriefingRespondstorequestsforconsultationinatimelymanner,andcommunicatesrecommendationstotherequestingteam

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

ICS2:CommunicationwithPatientsandFamiliesLevel1 Level2 Level3 Level4DemonstratesadequatelisteningskillsCommunicateseffectivelyinroutineclinicalsituations

ChecksforpatientandfamilyunderstandingofillnessandmanagementplanAllowsforopportunitiesforpatientquestionsMaintainscommunicationwithpatientandfamilyregardingplanofcare

Communicateseffectivelywithpatientsandfamiliesacrossabroadrangeofsocio-economicandculturalbackgroundsCommunicateseffectivelyinstressful,emergent,andcomplexsituations(e.g.,complications,poorprognosis,patientdeath)

RolemodelseffectivecommunicationCapableofinformingpatientsandfamiliesaboutamedicalerrorthatcausedharm

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐