Assessing Competency in Cardiovascular Training Programs

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Assessing Competency in Cardiovascular Training
Programs
Duane S. Pinto, M.D. Director Peripheral
Angiographic Core Laboratory, TIMI Data
Coordinating Center
Director, Cardiology Fellowship Training
Program Interventional Cardiologist, Beth Israel
Deaconess Medical Center
Assistant Professor of Medicine, Harvard Medical
School
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What? Knowing the Pressure ½ Time Isnt Enough?

• A competency based curriculum differs from the
  goals and objectives of each rotation and from
  the policies and procedures for your fellowship
• It also differs from what we actually want to
  assess when we deem a fellow cardiovascularly
  competent after a (CCU, CATH, CHF, etc) rotation!

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Competency Curriculum for the CCU/Inpatient
Service
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Competency Curriculum for the CCU/ Inpatient
Service
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Competency Tools That I Use

• Documentation of Achievement/Readiness for
  Practice of Cardiology
• Mid Year Evaluation
• Summative Evaluation
• Cath Lab Competency Measurement Tool
• Echo Lab Competency Measurement Tool

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Mid-Year Meeting
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Multiple Competencies-Multiple Tools
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Practical Issues in Assessing Competency

• How do we tell the difference between a July
  and June Fellow
• How to we apply concrete metrics to avoid
  confusion amongst the fellows?
• How do you deal with different rates of skill
  acquisition and ability?
• How do you document graded responsibility?
• How do you document achievement of a minimum
  standard?

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A Form, Of Course! Echo Lab Example
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Cath Lab Competency Example
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Assessing Outcomes at the End of the Year

• Development of Outcome Measures
• End of Year Quality Report
• How Good Was Your Fellowship Last Year?
• If you have a reliable way to measure that, then
  you are a genius!

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Example Recruitment
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Example Program
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Example Graduates
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Summary

• We have numerous tools available to us
• Having at least two ways to assess each ACGME
  competency for each rotation is required
• Formal competency evaluation does have a role in
  Cardiology Fellowships
• Using a few helpful tools makes assessment,
  documentation and feedback easy

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