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Integrating the chronic-care model and the ACGME competencies: using shared medical appointments to focus on systems-based practice

¹ Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA
² Case Western Reserve University School of Medicine, Cleveland, OH, USA

Correspondence to:
S R Kirsh, Medical Service (111W), Louis Stokes Cleveland VA Medical Center, 10701 East Blvd., Cleveland, OH 44106, USA; susan.kirsh@med.va.gov

The first 150 words of the full text of this article appear below.

There is an increasing need for physician trainees to learn management of chronic illness. Training in chronic illness management is complicated by the acute care orientation of most healthcare systems. Coming on top of the broadening range of competencies that reflect the changing needs of healthcare delivery is the shift in evaluation of physician trainees in several countries to competency-based methods.^{1 2} The Accreditation Council for Graduate Medical Education (ACGME) has defined six core competencies: systems-based practice, practice-based learning and improvement, patient care, medical knowledge, interpersonal and communication skills and professionalism.³ Explicitly included now are two competencies essential for effective patient care and quality improvement—Systems Based Practice (SBP) and Practice Based Learning and Improvement (PBLI). Although all six competencies apply to management of chronic illness, these two have been the most difficult for residency programmes to address in any comprehensive manner.^4–6 Training venues that mesh a systems approach to high-quality outpatient . . . [Full text of this article]