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photo_PainClinic.jpgThe way students are graded (assessment) drives student behavior. It is, therefore, imperative that the assessment system is well-aligned with the knowledge, skills and attitudes (or competencies) expected of the graduating physician; we refer to this as competency-based assessment or CBA.

Competency-based assessment does not equate attaining minimal competence. Rather, performance is defined in domains of competency, and learners are expected to continually strive for excellence in each domain. Milestones are descriptions of the typical developmental growth within each domain. The student receives reports showing one’s current level of performance along the milestones, and can see what behaviors are expected to attain the next level of performance.

At Vanderbilt, we use the domains defined by the Accreditation Council for Graduate Medical Education (ACGME) that are used to describe the performance of residents. Within each domain, there are multiple competencies (see Competencies for Learners Across the Continuum). We have selected some of the competencies within each domain that can be measured throughout all levels of medical school training; these are the “focus competencies” for which we have created milestones that describe medical student growth in these areas. Each student receives regular reports about his or her progress along these milestones, and works with his or her Portfolio Coach to understand the feedback and generate a Personalized Learning Plan.

Focus Competencies

The following competencies are covered by current milestones. (VUNet ID required)

Medical Knowledge

  • Demonstrate knowledge (MK2)
  • Process by which one acquires knowledge (MK7)

Patient Care

  • History (PC1)
  • Clinical reasoning: differential and prioritization (PC2)
  • Clinical judgment (PC7)

Interpersonal and Communication

  • Diversity with which people perceive, think, learn, communicate, decide (ICS2, in PR8)
  • Effective communication with (ICS7)
    • Patients and families
    • Peers
    • Teachers
    • Clinical teams
  • Effectively manage conflict; provide/receive feedback (ICS9, in PBLI3)

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  • Duties and obligations of the profession (PR1)
    • timeliness
    • accountability
    • demeanor in class or clinic
  • Honesty and transparency (PR5)
  • Compassion and respect for all (PR8)

Practice-based Learning & Improvement

Applied to “learning system” as well as health care

  • Continuous pursuit of learning (PBLI 2, in MK7)
  • Receptivity to feedback (PBLI3)
  • Initiative in seeking feedback (PBLI3)
  • Use data to identify learning needs and implement learning strategies (PBLI3)

Systems-based Practice

Applied to “learning system” as well as health care

  • Elements of effective team building (SBP2)