Competency Based Goals and Entrustable Professional Activities (EPAs)

Patient Care

Goal:

Fellows must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health in a culturally sensitive and family centered model.

EPAs:

 Fellows will:

• Gather essential and accurate information about the patient using medical interviewing, physical examination, and developmental assessment.
• Make informed diagnostic decisions and therapeutic recommendations based on patient information, cultural setting, family structure (foster care, etc), current scientific evidence, and clinical judgment.
• Develop and document concise consultant level reports that include pertinent history, neurodevelopmental examination, office-based developmental screening, and family-focused, community-based recommendations.

Medical Knowledge

Goal:

Fellows must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care in an inter-disciplinary system of health care.

EPAs:

Fellows will demonstrate knowledge including presentation, natural history, co-morbidity, and outcome of the following Neurodevelopmental disorders:

• 1. intellectual disability.
  2. autism spectrum disorders.
  3. speech and language disorders.
  4. learning disability.
  5. major sensory impairments.
  6. ADHD.

Fellows will:

• understand the important historical information required to assess the possible etiologies for developmental delay/disabilities.
• know the appropriate laboratory evaluation for developmental delay.
• know the indications for different types of molecular genetic tests.
• know the indications for cytogenetic testing.
• know the indications for biochemical/metabolic testing.
• know the indications for neuroimaging.
• understand the importance of identifying child and family strengths in the process of planning interventions.

Practice-Based Learning and Improvement

Goal:

Fellows learn to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning.

EPAs:

Fellows will:

• systematically analyze practice using quality improvement methods; implement changes with the goal of practice improvement.
• participate in the education of patients, families, students, residents, and other health professionals, as documented by evaluations of a fellow’s teaching abilities by faculty and/or learners,
• inform caregivers of a diagnosis of a developmental disability, behavioral/mental health disorder, or life-threatening condition.
• sensitively and effectively elicit parents’ opinions and concerns for their child’s development.
• communicate with primary care providers, birth to three centers, and special education programs to advocate for patients with a variety of developmental conditions.
• actively participate in interdisciplinary care conferences.

Systems Based Practice

Goal:

To demonstrate an awareness of, and responsiveness to, the larger context and system of health care, as well as the ability to call effectively on other resources in the local, regional, state and federal system to provide optimal health care to children and families.

EPAs:

Fellows will:

• work in interdisciplinary teams to enhance patient safety and improve quality of patient care. 
• actively participate in interdisciplinary team conferences, including leading the discussion and coordinating the parent feedback session.

Professionalism:

Goal:

Fellows must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles.

EPAs:

Fellows will

• demonstrate humility and responsiveness to a diverse patient population, including, but not limited to diversity in race, gender, age, culture, religion, disabilities, and sexual orientation.
• approach differing diagnostic and management recommendations from diverse professional disciplines with curiosity to promote learning, interdisciplinary collaboration, and excellent clinical care. 
• maintain comprehensive, timely, and legible medical records.

Interpersonal and Communication Skills

Goal:

Fellows must demonstrate interpersonal and communication skills that result in the effective exchange of information and development of partnerships with patients, their families, and professional associates.

EPAs:

Fellows will

• communicate sensitively, effectively, and compassionately with patients and families with diverse socioeconomic and cultural backgrounds.
• work sensitively, effectively, and compassionately as a member and/or leader of a health care team comprised of individuals with diverse personal and professional backgrounds.
• maintain comprehensive, timely, and legible medical records.

Teaching Methods

• Weekly core seminars with emphasis on public health, Title V legislation, Children with Special Healthcare Needs (CSHCN), introduction to neurodevelopmental and related disabilities, interdisciplinary and leadership skills, and understanding of family-centered, culturally competent care.
• Supervised patient care experiences.
• Direct hands-on training using the and other standardized assessments.
• Selected readings and other sources suggested by faculty  (see below)

Assessment Method (Fellow)

• Direct observations (in-room or through the observation mirror) by faculty of fellow-patient interactions and patient assessments with immediate feedback.
• Direct observation by faculty of fellow during team conferences with immediate feedback regarding fellow’s leadership abilities and contributions during the team discussion.
• Semi-annual evaluation by faculty on MedHub utilizing input from other members of the inter-disciplinary team.
• Semi-annual evaluation by staff/families/disciplines on ACGME teams
• Self-evaluation through use of the fellow’s Individualized Learning Plan.

Assessment Method (Program Evaluation)

• End-of-rotation evaluation on MedHub
• Direct feedback to Medical Director or supervising Developmental Pediatric Faculty
• Confidential Program Evaluation, which is reviewed during the semi-annual educational program review.

Level of Supervision

• Fellows evaluate all patients while being observed / supervised by UW Faculty.
• Fellows are expected to summarize and present clinical diagnoses and intervention recommendations to faculty with minimal direction.