Accreditation Council for Graduate Medical Education

1

Accreditation Council for Graduate Medical
Education
RRC Emergency Medicine CORD Update at
ACEP Annual Meeting October 8, 2007Louis
Binder, M.D.
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Accreditation Council for Graduate Medical
Education
RRC-EM Composition Spring 2007 AMERICAN BOARD
OF EMERGENCY MEDICINE Dane Chapman, M.D. Mary
Ann Reinhart, Ph.D, Ex-officio Daniel Danzl,
M.D. Rebecca Smith-Coggins, M.D. COUNCIL ON
MEDICAL EDUCATION (AMA) Louis S. Binder, M.D.
Charles K. Brown, M.D. Robert Muelleman, M.D,
Vice-Chair. AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS Mark Hostetler M.D., MPH Marjorie
Geist, Ph.D., Ex-officio David Overton,
M.D. Sandra Schneider, M.D., Chair EMERGENCY
MEDICINE RESIDENTS ASSOCIATION Camie Sorensen,
M.D., MPH

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Accreditation Council for Graduate Medical
Education
RRC-EM Composition Summer 2008 AMERICAN BOARD
OF EMERGENCY MEDICINE Michael Beeson, M.D.
Mary Ann Reinhart, Ph.D, Ex-officio Wallace
Carter, M.D. Jeffrey Graff, M.D. COUNCIL ON
MEDICAL EDUCATION (AMA) Samuel Keim, M.D. Robert
Muelleman, M.D, Vice-Chair. Susan Promes,
M.D. AMERICAN COLLEGE OF EMERGENCY
PHYSICIANS Mark Hostetler M.D., MPH Marjorie
Geist, Ph.D., Ex-officio Victoria Thornton,
M.D. Sandra Schneider, M.D., Chair EMERGENCY
MEDICINE RESIDENTS ASSOCIATION Michael Tocci, M.D.

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Accreditation Council for Graduate Medical
Education
Accreditation Activity, September 2007
Meeting29 EM programs reviewed 3 new
applications, 14 Surveys, 1 previously deferred
program decision, 2 progress reports, 6
complement changes, 1 duty hour report, and 2
format changes. Also 12 subspecialty
programs, 6 applications, 5 surveys, 1 progress
report, and 1 complement .Of 19 surveyed
programs12 Ongoing Accreditation 2 Initial
Accreditation 6 5 years accreditation 2
4 years accreditation 7 3 years
accreditation
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Accreditation Council for Graduate Medical
Education
New EM programs/fellowships at September 2007
MeetingEmergency MedicineHospital Episcopal
San Lucas/Ponce School of Medicine, Puerto Rico
Program Director - Carlos Garcia-Gubern, M.D.. PG
1-3 program, 6/year University of Texas Medical
Branch at GalvestonProgram Director - Brian
Zachariah, M.D., PG 1-3 program,
8/yearToxicologyCook County Hospital -
Program Director Steven Aks, D.O., 2/year
Health Partners/Hennepin Co Med Ctr - PD
Andrew Toplliff, M.D., 1/yearUndersea and
Hyperbaric MedicineLSU at New Orleans Program
Director Paul Horsch, M.D., 5/yearHennepin
County Medical Center PD Robert Collier,
M.D., 1/year
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Accreditation Council for Graduate Medical
Education
Most Common RRC-EM Citations, Spring 2007 (same
as for 2006)Procedure/Resuscitation experience
(12)Patient care experience (10)Responsibiliti
es of Program Director (12)Qualifications of
faculty (15)Responsibilities of faculty
(10)Scholarly Activity (5)
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Accreditation Council for Graduate Medical
Education
RRC-EM Pilot Project update34 programs
currently in the pilot, 6 with concernsFrom
RRC-EM perspective, going well Dashboard
indicators seem to function well in signifying
when a program becomes problematicACGME
Monitoring Committee review, September 2007
very favorable. Only suggestion was
recommendation to develop an overall evaluation
plan that explicitly assesses the success of the
project through data collection. We are giving
thought to how to implement thisMeeting today
between RRC and Pilot Program PDsNext
Monitoring Committee review in September, 2009
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Accreditation Council for Graduate Medical
Education
PIF Transition DocumentPrevious PIF Competency
Addendum discontinued on 7/1, with the intention
of adding in-common PIF questions across
specialties that ask about the competenciesThe
common PIF inserts were not ready on 7/1, so the
PIF Transition Document was devised for programs
being accredited this fall This document will
be discontinued as of 12/10/07, at which time,
each specialtys PIF will be revised to include
these questionsSome significant differences
between the questions in the competency addendum
and the transition document, but all are
consistent with the beginning of Phase 3 of the
Outcomes Project(Programs must use resident
performance data as the basis for improvement in
the program, and provide evidence of doing
so)Conceptually makes sense, but communication
on this not ideal
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Accreditation Council for Graduate Medical
Education
CILE PilotsACGME wants to encourage
flexibility/innovation to experiment with
refinements to meeting the General Competencies
and Duty Hrs requirementsCILE developed a
number of draft educational pilot innovations
that could be offered to programs. PARTICIPATION
IS VOLUNTARY !!!Programs individually
volunteer, sending a letter of interest to the
RRC-EM. RRC-EM has responsibility to assign
programs to pilotsPrograms must get GMEC
approval for participationDuration of pilots is
2 years. Year 1 random assignment to pilot
implementation vs. wait list. Year 2 all
programs assigned the interventionRigorous data
collection in participating programs by CILE
staffIncentives exemption from selected
CPRs, delay of next accreditatn.
reviewSolicitation will be coming over the
winter months give consideration to any you may
be interested in
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Accreditation Council for Graduate Medical
Education
RRC-EM GuidelinesED based Call Rooms must be
available to EM residentsScholarship
guideline 80 of core faculty must produce one
piece of scholarship per year (old) Must be
1 peer reviewed pub per each 5 core faculty
members per year (old) PD must be among the 80
of faculty producing one piece of scholarship
per year (new)
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Accreditation Council for Graduate Medical
Education
RRC-EM Guideline in Development Didactic
Formats, Innovation, and Asynchronous
EducationIn response to 1 programs request
for an extensive simulation curriculum (approved
by the RRC), RRC discussion was enthusiastic
about encouraging educational innovation (active
learning formats) within programs. Draft of
guideline produced to this effect, but will be
modified RRC is rethinking the purpose of EM
didactics, and guidelines should reflect
thisGist of CORD listserve discussion is
educational flexibility in format and timing, to
allow didactic credit on away/difficult rotations
and post night shift, but with healthy interest
in active learning formats. Some difference in
directions, but we are close enoughRecognized
by both groups that accountability and
verification will be important in whatever
guidelines for EM didactics are implemented
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Accreditation Council for Graduate Medical
Education
Issues that have come up so farEducational
InnovationMajority of conference time (60)
could be devoted to active formatsRRC-EM should
provide flexibility to programs to innovate, to
use what resources they have available in their
setting, and to match didactic content to the
pedagogy selectedBest formats might be on-line
curricula, simulation sessions, small group
learning formats that meet at different
timesFlexibility in format and
timing/accountabilityStipulated conferences for
asynchronous format (not M/M, J club)Stipulated
circumstances for asynchronous learning
(distance rotation, rigorous rotation, post
night shift)Limited number of asynchronous
conferences/resident/yearVerification that
resident subsequently did the alternative
format??Documented opportunity for interaction
with presenter for question??Some documentation
of resident learning quiz, resident e-mailEACH
RESIDENT MUST STILL GET 5 HRS/WK OF EDUCATION
FROM THE RESIDENT PERSPECTIVE, AND ATTEND 70 OF
EXPERIENCES