Graduate Medical Education

Practice Based Learning and Improvement

ACGME Common Program Requirements state that each residency/fellowship program must require its residents/fellows to obtain competence Practice Based Learning and Improvement. It is necessary for programs to define the specific knowledge, skills, behaviors, and attitudes required, as well as provide educational experiences as needed in order for their residents and fellows to demonstrate competency in the area of Practice Based Learning and Improvement.

Practice based learning and improvement requires the resident/fellow investigate and evaluate their care of patients, appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self evaluation and life-long learning. Residents/fellows are expected to develop skills and habits to be able to:

Identify strengths, deficiencies, and limits in one's knowledge and expertise;
Set learning and improvement goals;
Identify and perform appropriate learning activities;
Systematically analyze practice, using quality improvement methods, and implement changes with the goal of practice improvement;
Incorporate formative evaluation feedback into daily practice;
Locate, appraise, and assimilate evidence from scientific studies related to their patients' health problems;
Use information technology to optimize learning; and
Participate in the education of patients, families, students, residents and other health professionals, as documented by evaluations of a resident's teaching abilities by faculty and/or learners.

Program Improvement activities assure full integration of this and other competencies with learning and clinical care. To review several recommended evaluation methodologies, click here.

Core Assessment Systems are essential to improving resident performance in this competency as well as the other competencies. To review an example of comprehensive core assessment system, which uses multiple methodologies and raters, click here.

Key Components:

Life-long learning and practice improvement (self-reflection)

Appraisal and assimilation of scientific literature (EBM)

Able to implement quality improvement

Actively participate in the education of others

Common Program Requirements (effective 7/1/07) are available at the ACGME website. ACGME also has provided a Program Director's Guide to the Common Program Requirements that became effective 7/1/07.

Examples of Practice Based Learning and Improvement Curricula:

Examples of Practice Based Learning and Improvement Evaluation Tools:

Evaluation of Competencies (generic competencies)
Evaluation of Competencies for Evidence Based Medicine/Research
Annual Evaluation Form with Competencies (use for promotion)
Summary Evaluation Form with Competencies (use for graduation)

ACGME also has provided a Reference List as well as documented several Approaches to Assessment of Practice Based Learning and Improvement competency. They also have a toolbox of recommended methods for assessment you may wish to review.

This page was last updated on: January 23, 2008.