What indicates competency in systems based practice? An analysis of perspective consistency among healthcare team members

Mark J. Graham, Zoon Naqvi, John A. Encandela, Carma L. Bylund, Randa Dean, Ayxa Calero-Breckheimer, Hilary J. Schmidt

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

In many parts of the world the practice of medicine and medical education increasingly focus on providing patient care within context of the larger healthcare system. Our purpose is to solicit perceptions of all professional stakeholders (e.g. nurses) of the system regarding the U.S. ACGME competency Systems Based Practice to uncover the extent to which there is agreement or discrepancy among key system stakeholders. Eighty-eight multidisciplinary personnel (n = 88) from two academic medical centers were invited to participate in one of 14 nominal group process sessions. Participants generated and prioritized resident characteristics that they believed were important for effective System Based Practices. Through content analysis the prioritized attribute statements were coded to identify embedded themes of resident roles and behavior. From the themes, three major resident roles emerged: resident as Self-Manager, Team Collaborator, and Patient Advocate. No one professional group (e.g., nurses, attending physicians, social workers) emphasized all of these roles. Some concepts that are emphasized in the ACGME definition like using cost-benefit analysis were conspicuously absent from the healthcare team generated list. We showed that there are gaps between the key stakeholders prioritizations about the ACGME definition of SBP and, more generally, the behaviors and roles identified by healthcare team stakeholders beyond the U.S. This suggests that within the process of developing a comprehensive working understanding of the Systems Based Practice competency (or other similar competencies, such as in CanMEDS), it is necessary to use multiple stakeholders in the system (perhaps including patients) to more accurately identify key resident roles and observable behaviors.

Original languageEnglish (US)
Pages (from-to)187-203
Number of pages17
JournalAdvances in Health Sciences Education
Volume14
Issue number2
DOIs
StatePublished - May 2009
Externally publishedYes

Fingerprint

Patient Care Team
stakeholder
resident
Nurses
Group Processes
Medical Education
Cost-Benefit Analysis
Patient Care
Medicine
nurse
Delivery of Health Care
Physicians
cost-benefit analysis
patient care
social worker
content analysis
personnel
Group
physician
medicine

Keywords

  • CanMEDS
  • Nominal group process
  • Resident competency
  • Systems base practice
  • United States Accreditation Council on Graduate Medical Education

ASJC Scopus subject areas

  • Medicine(all)
  • Education

Cite this

What indicates competency in systems based practice? An analysis of perspective consistency among healthcare team members. / Graham, Mark J.; Naqvi, Zoon; Encandela, John A.; Bylund, Carma L.; Dean, Randa; Calero-Breckheimer, Ayxa; Schmidt, Hilary J.

In: Advances in Health Sciences Education, Vol. 14, No. 2, 05.2009, p. 187-203.

Research output: Contribution to journalArticle

Graham, Mark J. ; Naqvi, Zoon ; Encandela, John A. ; Bylund, Carma L. ; Dean, Randa ; Calero-Breckheimer, Ayxa ; Schmidt, Hilary J. / What indicates competency in systems based practice? An analysis of perspective consistency among healthcare team members. In: Advances in Health Sciences Education. 2009 ; Vol. 14, No. 2. pp. 187-203.
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