Clinical Competency Committees
Transcript Clinical Competency Committees
What Faculty need to know
Academic Affairs Committee
WHAT…are Clinical Competency
A group of faculty members tasked with
Assessing resident performance and progress based on multisource data
Determining individual resident’s level on Milestones
Making formal recommendations to the PD regarding
remediation, promotion and graduation
WHAT...are the (EM) Milestones?
23 (core) SKILLS, KNOWLEDGE AREAS, ATTITUDES
Specific to the 6 CORE COMPETENCIES FOR EM
(PC, MK, PROF, ICS, PBLI, SBP)
Organized in developmental framework of levels 1-5
2-3 mid level resident advancing appropriately
4 target for graduation
5 expert level
Descriptors of levels
1. (pc-1) Resuscitation
8. (pc-8) Multi-tasking
2. (pc-2) H&P
9. (pc-9) Procedures
3. (pc-3) Labs/Studies
10. (pc-10) Airway
4. (pc-4) DDx
11. (pc-11) Pain
5. (pc-5) Pharmacotherapy
6. (pc-6) Reassessment, F/U
7. (pc-7) Disposition
12. (pc-12) ED Ultrasound
13. (pc-13) Wound manage
14. (pc-14) Vascular Access
EM Milestones continued…
15. (mk-1) Medical knowledge
16. (prof-1) Compassion,
Integrity, Respect, Ethics
17. (prof-2) Accountability to
society, patients, profession
18. (ics-1) Patient centered
19. (ics-10) Team Managment
20. (pbli-1) Follow up, CQI,
21. (sbp-1) Patient safety—
SBAR, handoffs, checklists…
22. (sbp-2) Efficiency, flow
23. (sbp-3) Technology (EMR),
data and information access
WHY… is my program initiating
ACGME mandate: ALL programs must have CCC’s up and
running by July 2013 as part of the Next Accreditation
All programs begin reporting aggregate data on
residents’ milestone achievement by December 2013.
In NAS, CCC’s are integral in the process of interpreting
data and assigning milestone levels.
What purpose does the ACGME hope to accomplish by
requiring programs to establish CCC’s?
Increase the validity and accuracy of program assessment of
resident competence throughout training and at graduation.
Provide the benefit of “the insight and perspective of a group”
to the resident evaluation process.
Assure that programs detect resident deficiencies EARLY and
provide meaningful recommendations for remediation.
Ultimately assure the competence of graduates to practice
WHO…comprises the CCC?
The ACGME allows programs flexibility.
MUST include clinically active core faculty “dedicated to
MAY include non MD medical educators
PD,APD, core faculty
Faculty who primarily supervise in clinical setting
Involved nursing staff
HOW will the CCC’s function?
Meet quarterly, biannually, or more frequently as
necessary to allow semi-annual evaluation of each
Review multi-source data (previously compiled) for each
Come to consensus on resident’s achievement of
milestone level (possible milestone level 1-5).
Generate report with competency determination for
each resident with recommendation for advancement,
graduation or remediation.
HOW…will CCC’s function?
CCC Chair (Ideally NOT PD) directs process
Members must maintain confidentiality of proceedings
Deliberations, decisions and reports may be protected
(not discoverable) under peer-review confidentiality
depending on state laws.
Ongoing evaluation of CCC process to allow
recommendations for continued improvement of process
regarding activities of CCC
WHAT…are examples of data CCC
may use in resident assessment?
Direct observation data
Patient satisfaction data
Oral board performance
Structured chart review
How will CCC’s compile data?
Programs are free to develop Assessment Tools for
compiled data or use one already made.
Consistency of approach will increase accuracy even for
un-validated assessment tools.
WHAT…is the role of the PD?
Receives report/consensus determinations with
recommendations of CCC.
Includes report in resident record.
Carries responsibility of ultimate decision making with
regard to advancement, remediation, graduation.
FAQs ACGME Website: