University of Missouri-Columbia, Department of Emergency Medicine, Columbia, Missouri.
West J Emerg Med. 2019 Mar;20(2):357-362. doi: 10.5811/westjem.2018.10.37958. Epub 2018 Dec 5.
The use of competency-based milestones for emergency medicine (EM) was mandated by the Accreditation Council for Graduate Medical Education in 2013. However, clinical competency committees (CCC) may lack diverse, objective data to assess these new competencies. To remedy the lack of objective data when assessing the pharmacotherapy sub-competency (PC5) we introduced a unique approach that actively involves departmental clinical pharmacists in determining the milestone level achieved by the resident.
Our pharmacists assess the pharmacotherapy knowledge of the residents through multiple methods: direct observation of orders, communication with the residents while performing patient care within the emergency department (ED), and real-time chart review. This observation occurs informally on a daily basis in the ED and is incorporated into the routine work of the pharmacist. The pharmacists use the PC5 sub-competency as their standard evaluation tool in this setting to keep all assessments consistent.
Since our residency program introduced pharmacist assessment of resident pharmacotherapy knowledge, the CCC has conducted seven biannual meetings. Of the 120 separate PC5 sub-competency assessments made during those meetings there was 100% agreement between the pharmacist's assessment and the CCC's final assessment of the trainee. A survey of the CCC members concluded that the pharmacists' assessments were useful and aided in accurate resident evaluation.
The use of ED pharmacists in assessing the pharmacotherapy sub-competency provides important information used in resident assessment of the PC5 milestone.
2013 年,毕业后医学教育认证委员会要求将基于能力的里程碑方法用于急诊医学(EM)。然而,临床能力委员会(CCC)可能缺乏评估这些新能力的多样化、客观的数据。为了解决在评估药物治疗子能力(PC5)时缺乏客观数据的问题,我们引入了一种独特的方法,即让部门临床药师积极参与确定住院医师达到的里程碑水平。
我们的药师通过多种方法评估住院医师的药物治疗知识:直接观察医嘱、在急诊科为患者提供护理时与住院医师沟通以及实时图表审查。这种观察在急诊科日常非正式进行,并纳入药师的日常工作中。在这种情况下,药师使用 PC5 子能力作为其标准评估工具,以保持所有评估的一致性。
自我们的住院医师计划引入药师评估住院医师药物治疗知识以来,CCC 已经进行了七次半年一次的会议。在这些会议期间,共进行了 120 次单独的 PC5 子能力评估,药师评估与 CCC 对学员的最终评估之间达成了 100%的一致。对 CCC 成员的调查得出结论,药师的评估是有用的,并有助于对住院医师进行准确评估。
在评估药物治疗子能力方面,急诊科药师的参与提供了用于评估 PC5 里程碑的住院医师的重要信息。