In 1999, the Accreditation Council for Graduate Medical Education (ACGME) designed a program to outline a series of core competencies that should be a part of all graduate level medical training programs. The ACGME Core Competencies became the foundation of all initial and continuing education curricula. As such, all medical field graduates are assessed and evaluated according to these standards. The ultimate goal is for residents to be able to demonstrate and master the skill sets, behaviors, and attitudes outlined in these competencies, and in turn become medical professionals capable of providing quality health care.
The ACGME Core Competencies are now incorporated into all Graduate Medical Education (GME) training programs across the United States. The American Board of Medical Specialties (ABMS) has also integrated them into the Maintenance of Certification (MOC) program for continuing education certifications. All these endeavors work to ensure that all licensed and practicing physicians and residents are providing health care with skill sets designed to facilitate the best patient care and lead successful medical practices.
What Are the ACGME Core Competencies?
There are six designated ACGME Core Competencies. They include:
- Practice-Based Learning and Improvement
- Patient Care and Procedural Skills
- Systems-Based Practice
- Medical Knowledge
- Interpersonal and Communication Skills
Together, these competencies strive to measure physicians’ ability to administer a high level of care to their patients. This means diagnosing and treating illnesses; as well as offering strategies to prevent disease and to maintain and improve patients’ overall health and wellness. Finally, a physician will provide this care in a manner that recognizes and values the unique cultural background and emotions of every patient, thoughtfully including their families and support systems in every aspect of their care.
In Part 1 of this blog series, we listed the ACGME Core Competencies with a focus on EPAs and Milestones. Additional articles in this series have discussed Practice-Based Learning and Improvement, Patient Care and Procedural Skills, Systems-Based Practice, and Medical Knowledge.
Interpersonal and Communication Skills
To successfully master the ACGME Core Competency of Interpersonal and Communication Skills, a resident physician needs to demonstrate the ability to effectively exchange information with patients, their families, and professional associates.
Effective communication is a two-way street. It requires the resident to be both an active listener as well as a clear, articulate speaker. The ability to receive information is as important as the ability to transmit it to others. To do this, physicians must develop meaningful relationships with not only their patient but the patient’s family and the other medical professionals and health care team members they interact with on a daily basis.
The Interpersonal and Communication Skills core competency can be dissected into two subcompetencies. These are:
- Create and sustain a therapeutic relationship with patients and families
- Work effectively as a member or leader of a health care team
The ACGME Core Competencies: Subcompetencies for Interpersonal and Communication Skills
Interpersonal and communication skills are a combination of both verbal and nonverbal interactions with the people a resident works with and treats. To successfully share information, physicians must establish and maintain a foundation of trust with all parties so that the environment is open and encouraging for honest dialogue. Combining interpersonal and communication skills with accurate record keeping ensures that the information communicated throughout the treatment process is comprehensive, appropriate, and timely.
Create and Sustain a Therapeutic Relationship with Patients and Families
Physicians must maintain an open dialogue and flow of information between themselves and the patient in order to provide the best therapeutic care. This begins with identifying the primary providers of information (either the patient directly or a caregiver.) It also includes identifying themselves and the various health care team members and the role each plays in treatment. To demonstrate this subcompetency, the resident physician will use active listening skills during the initial and interval interviews and use appropriate language (based on the development and education level of the patient and caregivers). Residents will also use nonverbal techniques to elicit a thorough, accurate medical history. One can prompt nonverbal cues with open-ended, direct, or leading questions at various phases of the interviews.
Additionally, a resident will recognize the appropriate time and place for the exchange of information. They will be cognizant of the logistics of their unique work environments, such as public and private areas, choosing the appropriate settings for interviews, physical examinations, and discussions.
Finally, a physician will strive to maximize patient and family understanding of all lab and imaging results, diagnoses, and treatment options. Information and education will be provided both verbally and in written form. As necessary, the physician will reflect, clarify, confront, or interpret information during the patient encounter as well as during any interactions with the patient’s family and/or caregivers.
Work Effectively as a Member or Leader of a Health Care Team
Effective communication skills must extend beyond the patient to include the totality of the health care team a physician works with on a daily basis. This begins with assuming the proper role in the team, either as a contributing member or as the leader. The resident will communicate respectfully with all other team members, providing constructive written and verbal feedback as required. When leading a team, the resident must facilitate discussions and provide direction. Residents will willingly provide consultations to other physicians, health related agencies, or professional groups.
Maintaining accurate and comprehensive medical records is also a key component to mastering the communication core competency skill. Notes and correspondence must be legible and clear, using correct grammar and spelling to prevent misunderstanding. Residents should be willing to adopt technological improvements that optimize the sharing of information between providers, departments, and medical groups.
The ACGME Core Competency of Interpersonal and Communication Skills recognizes that resident physicians do not operate in a vacuum. Information must be translated and shared between the patients seeking treatment and the team of health care workers tasked with maintaining and improving their health and wellness. The effective transmission of information through a comprehensive understanding of the interpersonal and communication skills outlined in this core competency results in better understanding, fewer errors, and ultimately a higher quality of medical care for the patients.
Read more about the six ACGME Core Competencies: