Assessment

We have a well-rounded assessment system, to help our residents grow throughout their residency and reach their maximum potential.

Our assessment system is composed of:

  • Evaluations based on the national Pediatric Milestones, received from:
    • Faculty
    • Fellows
    • Residents
    • Medical Students
    • Nurses
    • Nurse Practitioners
    • Case Managers
    • Social Workers
    • Patients and Families

Click below to see the assessment forms used in the Stanford Pediatric Residency Program:

  • Evaluation A: Kaiser, Valley Wards, Valley NICU, Valley Nights, Oncology, WBN, PICN, Electives, Rainbow
  • Evaluation B: Blue, NF Blue/Yellow, NF Sup, Yellow, PICU, LPCH NICU, ACC, Adolescent
  • Evaluation C: Green, Red, NF Red/Green, Purple, Valley Outpatient, ED, DBP
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Clinical Competency Committee

  • Each resident has a longitudinal Clinical Competency Committee (CCC) that meets a minimum of twice per year to review how the resident is progressing through residency and identify areas of strength and areas to work on.  The CCC reviews 360-degree evaluations (listed above), along with the resident’s own self-evaluation.  The Clinical Competency Committee submits the residents’ milestone assessments to the ACGME twice yearly, and the class APD or coach meets with the resident to review the assessment.
  • The Clinical Competency Committee is composed of the:
    • Program Director
    • Class Associate Program Director
    • Coach
    • Chief Resident

Milestones

  • In 2012, the American Board of Pediatrics published 47 subcompetencies with associated milestones.
  • In 2013-2014, all pediatric residency programs need to report 21 of the subcompetencies with associated milestones.  We will be assessing these through our Coaching Initiative and our faculty, fellow, peer resident, nursing, patient, and self-evaluations.

Clinical Competency Committees

Each resident has a longitudinal Clinical Competency Committee (CCC) that meets a minimum of twice per year to review how the resident is progressing through residency and identify areas of strength and areas to work on. The CCC reviews evaluations from faculty, fellows, residents, medical students, nurse practitioners, nurses, social workers, patients, and families, along with the resident’s own self-evaluation. The Clinical Competency Committee submits the residents’ milestone assessments to the ACGME twice yearly, and the class APD or coach meets with the resident to review the assessment.

The Clinical Competency Committee is composed of the:

  • Program Director
  • Class Associate Program Director
  • Coach
  • Chief Resident

Entrustable Professional Activities (EPAs)

Entrustable Professional Activities (EPAs) offer a new method of assessment that focus on whether or not learners are ready to be entrusted to perform a set of professional activities without supervision. These EPAs are still being defined by pediatrics educators through the ABP and APPD, but their goal is to capture the key activities that practicing general pediatricians need for practicing pediatrics independently.

As described in Carol Carraccio and Ann Burke’s 2010 JGME paper “Beyond Competencies and Milestones: Adding Meaning Through Context:

EPA’s allow a “bridge to connect the [ACGME] competencies to “real world” and “real time” practice….EPAs are simply the routine professional-life activities of physicians based on their specialty and subspecialty. For example, an EPA for a pediatric hospitalist may be to “serve as the primary admitting pediatrician for previously well children suffering from common acute problems.” In order to perform this professional activity, a practitioner must (1) have knowledge of the signs and symptoms of these illnesses, (2) perform a physical examination to elicit confirmatory findings, (3) search for outcomes associated with specific therapeutic interventions, (4) communicate with the patient and the family about the management plan, (5) relate to families in a way that they understand, based on cultural background and health literacy, and (6) act as a liaison to the primary care physician who will see this patient in follow-up. Framing the 6 ACGME competencies within the clinical context of an EPA takes them out of the realm of the abstract and grounds them in a way that makes them meaningful to both learners and faculty.”

 

EPAs for Pediatrics (proposed by the ABP and APPD)

  • Provide consultation to other health care providers caring for children
  • Provide recommended pediatric health screening
  • Care for the well newborn
  • Manage patients with acute, common, single system diagnoses in an ambulatory, emergency, or inpatient setting.
  • Manage patients with acute complex multi-system disease in an ambulatory, emergency, or inpatient setting.
  • Provide a medical home for well children of all ages. (Entrustment decisions for this EPA may require stratification by age group)
  • Provide a medical home for patients with complex, chronic, or special health care needs. (Entrustment decisions for this EPA may require stratification by age group)
  • Recognize, provide initial management and refer patients presenting with surgical problems
  • Facilitate the transition from pediatric to adult health care
  • Assess and manage patients with common behavior/mental health problems.
  • Provide patient resuscitation, stabilization and triage that aligns care with severity of illness (Entrustment decisions for this EPA may require stratification by two age groups: neonate and non-neonate).
  • Manage information from a variety of sources for both learning and application to patient care
  • Refer patients who require consultation
  • Contribute to the fiscally sound and ethical management of a practice (e.g. through billing, scheduling, coding, and record keeping practices)
  • Apply public health principles and quality improvement methods to improve care for populations, communities, and systems
  • Lead and work within interprofessional health care teams
  • Facilitate handovers to another healthcare provider either within or across settings
  • Demonstrate competence in performing the common procedures of the general pediatrician
  • Engage in mindful practice