Saturday, April 25, 2009

Teaching the New Competencies Using the Gap Analysis Approach

http://www.stfm.org/fmhub/fm2006/April/Hershey238.pdf

Summary:

Doctors Bell and Kozakowski recommend using gap analysis to aid students (in this case medical students at all levels) in evaluating their current competency levels and developing a plan for improvement.

Medical schools typically define the core competencies that their students must meet upon the completion of classes, and at the end of the program. At the residency level, physicians must demonstrate achievement in the general competency categories, as identified by the Accreditation Council for Graduate Medical Education:
  • Patient Care
  • Medical Knowledge
  • Practice-Based Learning and Improvement
  • Interpersonal/Communication Skills
  • Professionalism
  • Systems-based practice.
Additionally, the authors describe the process of faculty-conducted assessments of the learners' achieved competencies. They provide a questionnaire used by faculty at the Lake Erie College of Osteopathic Medicine as an example.

Using gap analysis.
The authors describe the process of incorporating gap analysis into this type of self-evaluation. They mention four main steps:
  1. "Articulate a desired future state"
  2. "Describe the current state"
  3. "Examine internal and external issues that must be addressed to progress from the current state to the desired future state"
  4. "Delineate strategies and tactics that will ensure that the 'gap' between current state and desired future state is narrowed"
Gap analysis has been used in this application at the Hunterdon Medical Center Family Medicine Residency Program. Meetings are held between faculty and residents in which the residents are to score where they think fall, on a scale of 0-100, when performing a specific competency. The resident is then asked to name a practicing physician who he or she views as a 100 on the same scale. The faculty member asks the resident to identify those specific behaviors and characteristics that make the physician a 100. The last step involves the faculty member asking the resident to describe his or her own behaviors in relation to those of the 100-level physician, identifying specifics steps and learning issues that can reduce that gap between their own score and the 100-level score.

In the article's summary, the authors indicate that, at the time of publication, there had been no formal evaluation of this technique's effectiveness in this application.

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