Invited commentary: educational interventions to address the core competencies in surgery

Abstract

A HOST OF POWERFUL INFLUENCES from within the medical profession and strong pressures from the public have resulted in the recent intense focus on acquisition and maintenance of competence. The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS) have defined 6 core competencies that residents must acquire and practicing physicians must continue to demonstrate. These include medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice. Although these competencies are not entirely new to surgeons, efforts to teach and assess objectively specific elements within these competencies can be challenging. This is especially true for practice-based learning and improvement and systems-based practice, which have not received sufficient attention in most education programs. New and innovative methods are needed to address these 2 competencies. Interpersonal and communication skills and professionalism have traditionally been taught and learned through exemplary role modeling, and their assessment has been essentially subjective. Changes in the health care environment, such as the restriction on resident duty hours and shift of the venue of a major portion of surgical care from inpatient to ambulatory settings, have