Assessing residents' competency in care management: report of a consensus conference.
BACKGROUND
Residency programs must prepare physicians to practice in the current health care environment. This mandate is reflected in 3 of the 6 competency domains now required by the Accreditation Council for Graduate Medical Education: systems-based practice, interpersonal skills and communication, and practice-based learning and improvement.


CONCLUSIONS
An invitational conference was convened, with experts in clinical practice, managed care administration, and education to identify and recommend optimal and promising assessment methods for 4 target areas: physician-patient communication, ethics, teamwork and collaboration, and practice management. Working in small groups, participants considered a range of resident assessment methods and identified current or future methods for each area, based on reliability, validity, use of behaviorally oriented outcomes, feasibility, and cost. Preferred methods of assessment varied by domain and include written examinations, computer-based patient management problems, standardized patients, objective structured clinical examinations, portfolios, 360-degree evaluations, and patient satisfaction surveys.


CONCLUSIONS
The use of several practical, scientifically sound, and specific methods for assessing residents' competency in care management are recommended. Assessment instruments will need to be flexible enough to adapt to the rapid changes in the health care delivery system and terminology.
Department of Internal Medicine, University of Michigan, Ann Arbor 48109-0368, USA. jfrohna@umich.edu
John G
JG
Frohna
Adina
A
Kalet
Elizabeth
E
Kachur
Sondra
S
Zabar
Malcolm
M
Cox
Ralph
R
Halpern
Mariana G
MG
Hewson
Michael J
MJ
Yedidia
Brent C
BC
Williams
D002983:Clinical Competence; D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D007396:Internship and Residency; D010346:Patient Care Management; D010817:Physician-Patient Relations; D014481:United States