title: Do pediatric fellows recognize the importance and contribution of training to mastery of the general competencies?
abstract: BACKGROUND
  Six general competencies form the framework for accreditation of postgraduate fellowship programs and maintenance of certification for physician specialists. Fellows' perceptions of these competencies, however, remain unexplored.
  
  
  OBJECTIVE
  To examine fellows' perceptions of the importance of the competencies to medical education and the contribution of fellowship training to mastery of the competencies, and to explore the alignment of the competencies with critical learning experiences.
  
  
  METHODS
  Semi-structured interviews were conducted with 20 pediatric fellows in five divisions at one institution. Fellows recounted critical learning experiences, rated each competency for importance and contribution of training, and explained their ratings. Interviews were analyzed using standard qualitative methods.
  
  
  RESULTS
  Fellows assigned high ratings to medical knowledge and patient care for importance and contribution of training to mastery, referring to these competencies as 'staples of training'. They rated interpersonal and communication skills and professionalism higher for importance than contribution of training, viewing them as inherent traits or learned before fellowship. Fellows were unfamiliar with practice-based learning and improvement and systems-based practice and typically perceived them as secondary to training. Descriptions of critical learning experiences substantiated competency ratings for medical knowledge and patient care, but not practice-based learning and improvement.
  
  
  CONCLUSIONS
  Fellows perceive traditional knowledge and skills of medical practice as fundamental to postgraduate training, but other competencies as less central.
authors.affiliation: Center for Education Research and Evaluation, Columbia University Medical Center, 710W 168th Street, Room LL-10A, New York, NY 10032, USA. balmer@email.chop.edu
authors.forename: Dorene F
authors.initials: DF
authors.lastname: Balmer
authors.forename: Dee'ann
authors.initials: D
authors.lastname: Lisby
authors.forename: Mary Catherine
authors.initials: MC
authors.lastname: Harris
authors.forename: Gail B
authors.initials: GB
authors.lastname: Slap
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D005257:Fellowships and Scholarships; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010372:Pediatrics / Q000193:education*; D014481:United States