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A.A. Madu, R. Mammo, J. Manns, A. Fleury, P. Channa, J. Gurland, M. Mayers, H. Engel; Teaching Residents General Competencies By Exploding Preferred Practice Pattern Of The American Academy Of Ophthalmololgy . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4418.
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General competencies of ACGME include patient care, medical knowledge, practice based learning and improvement, interpersonal and communication skills, professionalism and systems based practice. Central to the teaching and implementation of general competencies is the concept of fostering a lifelong behavior of learning and improvement among residents. In order to implement and assess the general competencies, each resident evaluated their own patient care with appraisal and assimilation of scientific evidence and information technology to delineate ways to improve patient care. The benchmark used by the residents is the Preferred Practice Patterns (PPP) of the American Academy of Ophthalmology. PPP are practice guidelines developed without external financial support and based on the best available scientific information by ophthalmology experts. PPP offer an extensive array of disease processes ranging from adult cataracts to strabismus and amblyopia. In this project, each PPP was exploded to meet objectives of the general competencies.
Each resident evaluated a disease process in the clinic population. A PPP based data collection form was developed and presented. A sample case review is primary open angle glaucoma (POAG). Following presentation of the PPP, a second chart review was performed to assess compliance to the PPP recommendations. The general competencies were assessed based on the 9 point global resident evaluation form and resident work products were documented as portfolios.
In the sample test case 30 charts were reviewed, 15 before and 15 after the presentation of PPP for POAG. Compliance to PPP guidelines before and after was compared using Paired t–test. Mean compliance score before intervention = 80.71+ 28.45 and after intervention = 90.57 + 20.50. There is a statistically significant difference between the scores after intervention (p = 0.005) showing improvement.
This quality assurance, longitudinal project allowed the resident to develop competencies in the use of scientific evidence and information technology to improve patient care. This was done by exploding PPP to teach and implement the general competencies. It is the expectation that introducing residents to evidence based medicine using guidelines by a professional organization will foster a life long behavior of learning and improvement.
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