Competencies and learning objectives
The medical school faculty is embarking on a curriculum transformation plan starting with Year 1 being implemented July 2018. The Highways to Excellence curriculum develops more individualized educational experiences. The organ systems-based curriculum blends and reinforces basic sciences and clinical experiences from day one, integrating classroom, self-directed learning and small-group learning with clinical skills, cases, experience and training. The curriculum enables physicians-in-training to customize their studies, with time for electives and career choice exploration, including opportunities to focus on the health of underserved populations through community impact missions and partnerships.
Highways to Excellence Curriculum
This is the curriculum track for students who entered Wayne State University School of Medicine after June 2018. Learn more about the new Highways to Excellence Curriculum.
WSU SOM Curriculum
This is the curriculum track for students who entered Wayne State University School of Medicine before July 2018. Students who matriculated before the summer of 2018 may be enrolled in the WSU SOM Curriculum. New students cannot enter this track; it has been succeeded by the Highways to Excellence Curriculum track since July 2018.
Background Information
In 2013, the Association of American Medical Colleges (AAMC) synthesized over 150 competency lists from across medical education continuum, physician specialties and subspecialties, countries and healthcare professions to develop a list of common learner expectations utilized in the training of physicians and other health professionals: Physician Competency Reference Set (PCRS). These competencies define the desired outcomes across the continuum of education, training, and practice.
The AAMC also developed the 13 Core Entrustable Professional Activities for Entering Residency (EPAs) that all entering residents should be expected to perform on day 1 of residency without direct supervision regardless of specialty choice (see Appendix 1). The EPAs provide the clinical context for the PCRS competencies. Each EPA can be mapped to the competencies that are critical to making an entrustment decision. More information about the EPAs and development of curriculum for the measurement of entrustment is available in the AAMC's Publication: Core Entrustable Professional Activities for Entering Residency Curriculum Developers Guide.
New Institutional Domains of Competency and Competencies
In 2016, Wayne State University School of Medicine analyzed the current institutional learning objectives and decided to revised its competency domains and related competencies for the program leading to the MD degree. As a result, the new AAMC domains of competency were assumed and many institutional competencies changed; in some areas, the previous WSUSOM competencies were maintained but mapped to a PCRS competency and in other areas the new PCRS competencies were adopted. The new domains and competencies are intended to be in line with the AAMC's PCRS and to map the competencies to the EPAs. WSUSOM Undergraduate Medical Education Curriculum Committee approved the competency domains and competencies on 6/8/2016; they will be instituted beginning with the 2016-2017 academic year.
DOMAIN 1: KNOWLEDGE FOR PRACTICE (KP)
Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care
| Relevant Entrustable Professional Activities | Reference to the PCRS | WSUSOM Competency |
|---|---|---|
| EPA 1, 3, 13 | KP 1 | KP 1: Demonstrate an investigatory and analytic approach to clinical situations |
| EPA 2 | KP 2 | KP 2: Apply established and emerging biophysical scientific principles fundamental to health care for patients and populations |
| EPA 2, 7 | KP 3 | KP 3: Apply established and emerging principles of clinical sciences to diagnostic and therapeutic decision making, clinical problem solving, and other aspects of evidence-based health care |
| EPA 2, 3, 7 | KP 4 | KP 4: Apply principles of epidemiological sciences to the identification of health problems, risk factors, treatment strategies, resources, and disease prevention/health promotion efforts for patients and populations* |
| KP 5 | KP 5: Apply psychosocial principles and concepts in the delivery of health care, including assessment of the impact of psychosocial-cultural influences on health, disease, care-seeking, care-compliance, and barriers to and attitudes toward care* | |
| KP 6 | KP 6: Contribute to the creation, dissemination, application, and translation of new health care knowledge and practices |
* Represents a WSUSOM Undergraduate Medical Education mission based competency toward urban clinical excellence.
DOMAIN 2: PATIENT CARE (PC)
Provide patient-centered care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health
| Relevant Entrustable Professional Activities | Reference to the PCRS | WSUSOM Competency |
|---|---|---|
| EPA 10, 12 | PC 1 | PC 1: Perform routine technical procedures specified by the medical school and clerkship |
| EPA 1, 2, 4, 6, 10 | PC 2 | PC 2A: Take a satisfactory medical history including psychosocial, nutritional, occupational and sexual dimensions |
| EPA 1, 2, 4, 6, 10 | PC 2 | PC 2B: Perform a satisfactory physical exam |
| EPA 1, 2, 4, 6, 10 | PC 2 | PC 2C: Accurately document the clinical encounter |
| EPA 10, 11 | PC 3 | PC 3: Apply the concepts and principles of patient safety science in the delivery of clinical care |
| EPA 2, 3, 5, 10 | PC 4 | PC 4A: Apply laboratory and imaging methods in identifying diseases or health problems |
| EPA 2, 3, 5, 10 | PC 4 | PC 4B: Interpret laboratory data, imaging studies, and other tests required for the area of practice |
| EPA 3, 4, 10 | PC 5 | PC 5A: Utilize data from the history, physical exam and laboratory evaluations, with up-to-date scientific evidence to identify health problems |
| EPA 3, 4, 10 | PC 5 | PC 5B: Formulate an appropriate differential diagnosis |
| EPA 4, 5, 10, 11 | PC 6 | PC 6A: Formulate effective management plans (diagnostic, treatment, prevention strategies, including relieving pain and ameliorating the suffering of patients) for diseases and other health problems |
| EPA 4, 5, 10, 11 | PC 6 | PC 6B: Monitor the course of illnesses and to appropriately revise the management plan |
| EPA 3, 11, 12 | PC 7 | PC 7: Counsel and educate patients and their families to empower them to participate in their care and enable shared decision making* |
| EPA 8 | PC 8 | PC 8: Understand the need and value of consultations and referrals in the delivery of health care |
| EPA 3 | PC 9 | PC 9: Apply preventive and health maintenance principles and techniques in the delivery of health care* |
| PC 10 | PC 10: Provide appropriate role modeling | |
| PC 11 | PC 11: Perform supervisory responsibilities commensurate with one's roles, abilities, and qualifications | |
| PC 12 | PC 12: Diagnose and manage patients with common diseases and health-related conditions prevalent in urban settings* |
* Represents a WSUSOM Undergraduate Medical Education mission based competency toward urban clinical excellence.
DOMAIN 3: PRACTICE-BASED LEARNING AND IMPROVEMENT (PBLI)
Demonstrate the ability to investigate and evaluate one's care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning
| Relevant Entrustable Professional Activities | Reference to the PCRS | WSUSOM Competency |
|---|---|---|
| EPA 2, 4, 6, 7 | PBLI 1 | PBLI 1: Recognize personal educational needs and to select and utilize appropriate resources to optimize learning |
| PBLI 2 | PBLI 2: Set learning and improvement goals | |
| EPA 7 | PBLI 3 | PBLI 3: Identify and perform learning activities that address one's gaps in knowledge, skills, or attitudes |
| EPA 13 | PBLI 4 | PBLI 4: Systematically analyze practice using quality-improvement methods and implement changes with the goal of practice improvement |
| EPA 8 | PBLI 5 | PBLI 5: Incorporate feedback into daily practice |
| EPA 7 | PBLI 6 | PBLI 6: Locate, appraise, and assimilate evidence from scientific studies related to patients' health problems |
| EPA 4, 7, 8 | PBLI 7 | PBLI 7: Use information technology to optimize learning |
| PBLI 8 | PBLI 8: Participate in the education of patients, families, students, trainees, peers, and other health professionals | |
| EPA 3, 7 | PBLI 9 | PBLI 9: Obtain and utilize information about individual patients, populations of patients, or communities from which patients are drawn to improve care* |
| EPA 13 | PBLI 10 | PBLI 10: Recognize the need to engage in lifelong learning to stay abreast of relevant scientific advances |
* Represents a WSUSOM Undergraduate Medical Education mission based competency toward urban clinical excellence.
DOMAIN 4: INTERPERSONAL AND COMMUNICATION SKILLS (ICS)
Demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals
| Relevant Entrustable Professional Activities | Reference to the PCRS | WSUSOM Competency |
|---|---|---|
| EPA 1, 4, 5, 6, 11 | ICS 1 | ICS 1: Effectively interact with patients, peers, families and other healthcare workers from diverse cultural backgrounds* |
| EPA 2, 5, 6, 7, 8, 9, 10, 13 | ICS 2 | ICS 2: The ability to effectively communicate with peers and members of the healthcare team in the care of patients and their families |
| EPA 8, 9 | ICS 3 | ICS 3: The ability to work cooperatively with other health care workers in the delivery of health care |
| ICS 4 | ICS 4: Act in a consultative role to other health professionals | |
| EPA 5, 11, 12 | ICS 5 | ICS 5: Maintain comprehensive, timely, and legible medical records |
| EPA 10, 12 | ICS 6 | ICS 6: Demonstrate sensitivity, honesty, and compassion in difficult conversations (e.g.. about issues such as death, end-of-life issues, adverse events, bad news, disclosure of errors, and other sensitive topics |
| EPA 1, 9, 11 | ICS 7 | ICS 7: Demonstrate insight and understanding about emotions and human responses to emotions that allow one to develop and manage interpersonal interactions |
* Represents a WSUSOM Undergraduate Medical Education mission based competency toward urban clinical excellence.
DOMAIN 5: PROFESSIONALISM (P)
Demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles
| Relevant Entrustable Professional Activities | Reference to the PCRS | WSUSOM Competency |
|---|---|---|
| EPA 1, 6, 9 | P 1 | P 1: Demonstrate compassion, integrity, and respect for others, in particular people from vulnerable population* |
| P 2 | P 2: Demonstrate responsiveness to patient needs that supersedes self-interest | |
| EPA 1, 6, 8 | P 3 | P 3 Respect the patients' dignity, privacy, and confidentiality in the delivery of health care |
| EPA 5, 13 | P 4 | P 4: Demonstrate accountability to peers, patients, society, and the profession |
| EPA 1 | P 5 | P 5: Demonstrate sensitivity and responsiveness to diverse populations, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation* |
| EPA 12 | P 6 | P 6: Demonstrate a commitment to ethical principles pertaining to provision or withholding of care, confidentiality, informed consent, and business practices, including compliance with relevant laws, policies, and regulations |
| P 7 | P 7: Demonstrate credibility, initiative, integrity and professional competence needed to gain the confidence and respect of others while providing clinical care or other services to diverse populations in an urban setting* |
* Represents a WSUSOM Undergraduate Medical Education mission based competency toward urban clinical excellence.
DOMAIN 6: SYSTEMS-BASED PRACTICE (SBP)
Demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care
| Relevant Entrustable Professional Activities | Reference to the PCRS | WSUSOM Competency |
|---|---|---|
| EPA 5 | SBP 1 | SBP 1: Describe the health care delivery systems including social, economic and political dimensions |
| EPA 9 | SBP 2 | SBP 2: Coordinate patient care within the health care system relevant to one's clinical specialty |
| EPA 3, 4, 11, 12 | SBP 3 | SBP 3: Incorporate considerations of cost awareness and risk-benefit analysis in patient and/or population based care* |
| EPA 13 | SBP 4 | SBP 4: Advocate for quality patient care and optimal patient care systems to support and contribute to a culture of safety |
| EPA 13 | SBP 5 | SBP 5: Participate in identifying system errors and implementing potential systems solution |
| SBP 6 | SBP 6: Perform administrative and practice management responsibilities commensurate with one's role, abilities, and qualifications |
* Represents a WSUSOM Undergraduate Medical Education mission based competency toward urban clinical excellence.
DOMAIN 7: INTERPROFESSIONAL COLLABORATION (IPC)
Demonstrate the ability to engage in an inter-professional team in a manner that optimizes safe, effective patient and population-centered care
| Relevant Entrustable Professional Activities | Reference to the PCRS | WSUSOM Competency |
|---|---|---|
| EPA 9 | IPC 1 | IPC 1: Work with other health professionals to establish and maintain a climate of mutual respect, dignity, diversity, ethical integrity, and trust |
| EPA 9 | IPC 2 | IPC 2: Use the knowledge of one's own role and those of other professions to appropriately assess and address the health care needs of the patients and populations served* |
| EPA 9 | IPC 3 | IPC 3: Communicate with other health professionals in a responsive and responsible manner that supports the maintenance of health and the treatment of disease in individual patients and populations |
| IPC 4 | IPC 4: Participate in different team roles to establish, develop, and continuously enhance inter-professional teams to provide patient- and population-centered care that is safe, timely, efficient, effective, and equitable* |
* Represents a WSUSOM Undergraduate Medical Education mission based competency toward urban clinical excellence.
DOMAIN 8: PERSONAL AND PROFESSIONAL DEVELOPMENT (PPD)
Demonstrate the qualities required to sustain lifelong personal and professional growth
| Relevant Entrustable Professional Activities | Reference to the PCRS | WSUSOM Competency |
|---|---|---|
| PPD 1 | PPD 1: Develop the ability to use self-awareness of knowledge, skills, and emotional limitations to engage in appropriate help-seeking behaviors | |
| PPD 2 | PPD 2: Demonstrate healthy coping mechanisms to respond to stress | |
| PPD 3 | PPD 3: Manage conflict between personal and professional responsibilities | |
| EPA 6 | PPD 4 | PPD 4: Practice flexibility and maturity in adjusting to change with the capacity to alter behavior |
| PPD 5 | PPD 5: Demonstrate trustworthiness that makes colleagues feel secure when one is responsible for the care of patients | |
| PPD 6 | PPD 6: Provide leadership skills that enhance team functioning, the learning environment, and/or the health care delivery system | |
| EPA 6, 11, 12 | PPD 7 | PPD 7: Demonstrate self-confidence that puts patients, families, and members of the health care team at ease |
| EPA 2 | PPD 8 | PPD 8: Recognize that ambiguity is part of clinical health care and respond by using appropriate resources in dealing with uncertainty |
* Represents a WSUSOM Undergraduate Medical Education mission based competency toward urban clinical excellence.
13 Entrustable Professional Activities for Entering Residency
- Gather a history and perform a physical examination
- Prioritize a differential diagnosis following a clinical encounter
- Recommend and interpret common diagnostic and screening tests
- Enter and discuss orders and prescriptions
- Document a clinical encounter in the patient record
- Provide an oral presentation of a clinical encounter
- Form clinical questions and retrieve evidence to advance patient care
- Give or receive a patient handover to transition care responsibility
- Collaborate as a member of an interprofessional team
- Recognize a patient requiring urgent or emergent care and initiate evaluation and management
- Obtain informed consent for tests and/or procedures
- Perform general procedures of a physician
- Identify system failures and contribute to a culture of safety and improvement
References
Eglander, R, Cameron, T, Ballard, A, Dodge, J, Bull, J, Aschenbrener, C. Toward a Common Taxonomy of Competency Domains for the Health Professions and Competencies for Physicians: Acad. Med. 2013; 88: 1088-1094
Association of American Medical Colleges (AAMC). Core Entrustable Professional Activities for Entering Residency Curriculum Developers' Guide. 2014
Clerkship objectives