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Executive Summary
Pages 1-18

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From page 1...
... This follow-up report focuses on integrating a core set of competencies patientcentered care, interdisciplinary teams, evidence-based practice, quality improvement and informatics into health professions education. The report's recommendations include a mix of approaches related to oversight processes, the training environment, research, public reporting, and leadership.
From page 2...
... · These same clinicians are confronted with a rapidly expanding evidence base—upon which health care decisions should ideally be made but are not consistently schooled in how to search and evaluate this evidence base and apply it to practice (American Association of Medical Colleges, 1999; Detmer, 1997; Green, 2000; Shell, 20014. · Although there is a spotlight on the serious mismatch between what we know to be good quality care and the care that is actually delivered, students and health professionals have few opportunities to avail themselves of coursework and other educational interventions that would aid them in analyzing the root causes of errors and other quality problems and in designing systemwide fixes (Baker et al., 1998; Buerhaus and Norman, 20014.
From page 3...
... The committee's vision is apparent in selected institutions both academic and practice settings around the country, but is not incorporated into the basic fabric of health professions education, nor is it supported by oversight processes or financing arrangements. Accordingly, the committee proposes a set of five core competencies that all clinicians should possess, regardless of their discipline, to meet the needs of the 21 St-century health system.
From page 4...
... The committee recognizes that there are many other competencies that health professionals should possess, such as a commitment to lifelong learning, but believes those listed above are the most relevant across the clinical disciplines; advance the vision in the Quality Chasm report; and overlap with recent, existing efforts to define competencies (Accreditation Council for Graduate Medical Education, 1999; Accreditation Council on Pharmaceutical Education, 20004. The committee also acknowledges that the core competencies will differ in application across the disciplines.
From page 5...
... Integrating core competencies into oversight processes would likely provide the impetus for faculty development, curricular reform, and leadership activities. Common Language and Adoption of Core Competencies Before steps can be taken to integrate a core set of competencies into oversight processes, an interdisciplinary group that includes leaders from the professions, educational institutions, and oversight organizations will need to define common terms.
From page 6...
... Recommendation 1: DHHS and leading foundations should support an interdisciplinary effort focused on developing a common language, with the ultimate aim of achieving consensus across the health professions on a core set of competencies that includes patientcentered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. Integrating competencies into oversight processes The extent of integration of competencies into existing oversight processes varies.
From page 7...
... Further, research has raised questions about the efficacy of continuing education courses, the most common way to demonstrate ongoing competency (Cantillon and Jones, 1999; Davis et al., 19994. Efforts to incorporate a core set of competencies across the professions into the full oversight framework accreditation, licensing, and certification—would need to occur on the national, state, and local levels; coordinate both public- and private-sector oversight organizations;and solicit broadinput.
From page 8...
... These restrictions make less and less sense as health care organizations and health professionals cross state lines. Finally, the committee believes that there should be a focused effort to integrate a core set of competencies into oversight processes focused on practicing clinicians.
From page 9...
... . Consequently, the committee believes that initial support should be provided for existing exemplary practice organizations that partner with educational institutions, and are already providing the interdisciplinary education and training necessary for staff to consistently deliver care that incorporates the core competencies.
From page 10...
... There are many barriers to incorporating the five competencies into the practice environment, where medical residents and new graduates in allied health, nursing, and pharmacology obtain initial training that leaves an important imprint on their future practice (Partnership for Solutions, 2002~. In addition to the barriers of time constraints, oversight restrictions, resistance from the professions, and absence of political will, the overall health care financing system is a large impediment to integrating the core competencies into practice settings.
From page 11...
... should take the lead in funding experiments that will enable and create incentives for health professionals to integrate interdisciplinary approaches into educational or practice settings, with the goal of providing a training ground for students and clinicians that incorporates the five core competencies. Research and Information Along with oversight changes and supportive training environments, the committee believes that evidence of the efficacy of an educational intervention can be a catalyst for change.
From page 12...
... Recommendation 9: AHRQ should work with a representative group of health care leaders to develop measures reflecting the core set of competencies, set national goals for improvement, and issue a report to the public evaluating progress toward these goals. AHRQ should issue the first report, focused on clinical educational institutions, in 2005 and produce annual reports thereafter.
From page 13...
... As the work of integrating core competencies into oversight processes proceeds, the efforts of leading practice organizations to integrate the core competencies into care delivery should be fostered through regional demonstration learning centers and Medicare demonstration projects. Simultaneously with these efforts, AHRQ and private foundations should provide support for research focused on the efficacy of the competencies and competency education and, most important, develop a set of measures reflecting the core set of competencies, along with national goals for improvement.
From page 14...
... . Accreditation Council for Graduate Medical Education.
From page 15...
... 1999. Impact of formal continuing medical education: Do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes?
From page 16...
... 2002. Building and assessing competence: the potential for evidence-based graduate medical education.
From page 17...
... 1998. Recreating health professionalpractice for a new century - The fourth report of the PEW health professions Commission.
From page 18...
... 2002. "United States Medical Licensing Examination Steps 1, 2, 3." Online.


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