Download The Nuclear Radiology Milestone Project

The Nuclear Radiology
Milestone Project
A Joint Initiative of
The Accreditation Council for Graduate Medical Education
and
The American Board of Radiology
February 2014
The Nuclear Radiology Milestone Project
The Milestones are designed only for use in evaluation of fellows in the context of their participation in ACGMEaccredited residency or fellowship programs. The Milestones provide a framework for the assessment of the
development of the resident physician in key dimensions of the elements of physician competency in a specialty
or subspecialty. They neither represent the entirety of the dimensions of the six domains of physician
competency, nor are they designed to be relevant in any other context.
i
Nuclear Radiology Milestones
Chair: Lawrence P. Davis, MD
Working Group
Advisory Group
Manuel L. Brown, MD
Gary Becker, MD
Laura Edgar, EdD, CAE
Louis Ling, MD
Milton J. Guiberteau, MD
Kay H. Vydareny, MD
Petra J. Lewis, MD
M. Elizabeth Oates, MD
Umesh Oza, MD
ii
Milestone Reporting
This document presents milestones designed for programs to use in semi-annual review of fellow performance and reporting to the
ACGME. Milestones are knowledge, skills, attitudes, and other attributes for each of the ACGME competencies organized in a
developmental framework from less to more advanced. They are descriptors and targets for fellow performance as a fellow moves
from entry into fellowship through graduation. In the initial years of implementation, the Review Committee will examine milestone
performance data for each program’s fellows as one element in the Next Accreditation System (NAS) to determine whether fellows
overall are progressing.
For each period, review and reporting will involve selecting milestone levels that best describe a fellow’s current performance and
attributes. Milestones are arranged into numbered levels. Tracking from Level 1 to Level 5 is synonymous with moving from novice
to expert in the subspecialty.
Selection of a level implies that the fellow substantially demonstrates the milestones in that level, as well as those in lower levels
(see the diagram on page v).
Level 1: The fellow demonstrates milestones expected of an incoming fellow.
Level 2: The fellow is advancing and demonstrates additional milestones, but is not yet performing at a mid-fellowship level.
Level 3: The fellow continues to advance and demonstrate additional milestones, consistently including the majority of
milestones targeted for fellowship.
Level 4: The fellow has advanced so that he or she now substantially demonstrates the milestones targeted for fellowship. This
level is designed as the graduation target.
Level 5: The fellow has advanced beyond performance targets set for fellowship and is demonstrating “aspirational” goals
which might describe the performance of someone who has been in practice for several years. It is expected that only
a few exceptional fellows will reach this level.
iii
Additional Notes
Level 4 is designed as the graduation target and does not represent a graduation requirement. Making decisions about readiness for
graduation is the purview of the fellowship program director. Study of Milestone performance data will be required before the
ACGME and its partners will be able to determine whether milestones in the first four levels appropriately represent the
developmental framework, and whether Milestone data are of sufficient quality to be used for high-stakes decisions.
Examples are provided with some milestones. Please note that the examples are not the required element or outcome; they are
provided as a way to share the intent of the element.
Some milestone descriptions include statements about performing independently. These activities must occur in conformity to the
ACGME supervision guidelines, as well as institutional and program policies. For example, a fellow who performs a procedure
independently must, at a minimum, be supervised through oversight.
Answers to Frequently Asked Questions about the Next Accreditation System and Milestones are posted on the Next Accreditation
System section of the ACGME website.
Radiology Subspecialty Assessment tools:
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End-of-Rotation Global Assessment
Direct observation and feedback
Reading out with resident
Review of reports
Rate of major discrepancies
Self-Assessment and Reflections/Portfolio
OSCE/simulation
Completion of institutional safety modules, BCLS/ACLS
Case/Procedure Logs, including complications
Multi-Source Evaluations
iv
The diagram below presents an example set of milestones for one sub-competency in the same format as the ACGME Report
Worksheet. For each reporting period, a fellow’s performance on the milestones for each sub-competency will be indicated
by selecting the level of milestones that best describes that fellow’s performance in relation to those milestones.
Selecting a response box in the middle of a
level implies that milestones in that level and
in lower levels have been substantially
demonstrated.
Selecting a response box on the line in between levels
indicates that milestones in lower levels have been
demonstrated as well as some milestones in the higher
level(s).
v
Version 2/2014
THE NUCLEAR RADIOLOGY MILESTONES: ACGME REPORT WORKSHEET
Patient and Personnel Safety (Diagnostic and Procedural) — Patient Care 1
Level 1
Knows basic radiation
protection concepts (e.g., As
Low As Reasonably
Achievable [ALARA])
Level 2
Uniformly practices ALARA
principles for self, staff
members, patients, families,
and public
Knows basic considerations
for imaging females of
childbearing age, and those
who are pregnant/breastfeeding
Understands radiation dose
concerns as related to
radionuclide imaging, including
hybrid imaging, and can explain
risk/benefit
Safely handles and
administers
radiopharmaceuticals
Ensures that each patient
receives the appropriate
examination or therapy
Recognizes and manages
contrast reactions and
infiltrations
Treats common complications
from administered nonradioactive pharmaceuticals
(e.g., furosemide, morphine
sulfate, captopril)
Manages minor radioactive
spills
Comments:
Level 3
Knows the comparative
radiation exposures received
by patients for common
nuclear radiology
examinations and procedures
Level 4
Understands the management
of dose limit exceptions to
personnel or public from
nuclear radiology examinations
and therapeutic procedures
Optimizes
radiopharmaceutical dosages
based on patient parameters
(e.g., age, size, comorbidities,
pregnancy, nursing)
Knows the comparative
radiation exposures received
by patients for uncommon
nuclear radiology examinations
and procedures
Knows the relative and
absolute contraindications to
diagnostic and nuclear
radiology therapeutic
examinations (e.g., aortic
stenosis, exercise stress)
Reduces patient radiation
exposure through choice of
examination and protocol
optimization (e.g., hydration/
voiding)
Understands and adopts the
concepts of Image Wisely ®
and Image Gently ®
Level 5
Teaches patient and
personnel radiation
safety
Implements new safety
procedures and quality
control measures
impacting patient care
Understands the prevention
and management of
therapeutic
radiopharmaceutical
infiltrations
Not yet achieved Level 1
“Common” and “uncommon” to be defined by each program
Copyright (c) Pending. The Accreditation Council for Graduate Medical Education and the American Board of Radiology. All rights reserved. The
copyright owners grant third parties the right to use the Nuclear Radiology Milestones on a non-exclusive basis for educational purposes.
1
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THE NUCLEAR RADIOLOGY MILESTONES: ACGME REPORT WORKSHEET
Diagnostic Examinations: Patient Selection, Preparation, Examination Supervision, and Image Interpretation — Patient Care 2
Level 1
Evaluates imaging requests
and patient information, and
reviews previous
examinations
Proposes appropriate
examinations for common
conditions/clinical
presentations
Level 2
Selects and tailors protocols of
common examinations according to
patient information
Recommends appropriate patient
preparation (e.g., diet, medication)
Accurately makes core
observations/interpretations and
formulates appropriate differential
Accurately makes core
diagnoses for uncommon findings
observations/interpretations on common examinations
and formulates appropriate
differential diagnoses for
Correlates nuclear imaging with
common findings on
anatomical imaging, and compares
common examinations
to previous examinations
Is familiar with the range of
cardiac stress methods and
protocols
Narrows the differential diagnosis
and describes management options
Recognizes the implications of the
adequacy of cardiac stress on
examination interpretation
Comments:
Level 3
Appropriately supervises
adequacy and
completeness of common
examinations
Makes accurate, efficient,
and focused
interpretations of
uncommon examinations,
including secondary
findings
Prioritizes differential
diagnoses and
recommends appropriate
management
Level 4
Selects and tailors
protocols of uncommon
examinations according to
patient information
Appropriately supervises
adequacy and
completeness of
uncommon examinations
and complex cases
Makes subtle observations
and suggests a single
“best” diagnosis, when
appropriate, on all
examinations
Level 5
Teaches diagnostic
nuclear imaging to other
learners
Acts independently as a
consultant on
interdisciplinary teams
Presents or publishes
nuclear radiology
research in peerreviewed media
Integrates current
literature and national
practice guidelines into
daily work
Not yet achieved Level 1
“Common” and “uncommon” to be defined by each program
Copyright (c) Pending. The Accreditation Council for Graduate Medical Education and the American Board of Radiology. All rights reserved. The
copyright owners grant third parties the right to use the Nuclear Radiology Milestones on a non-exclusive basis for educational purposes.
2
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THE NUCLEAR RADIOLOGY MILESTONES: ACGME REPORT WORKSHEET
131
Radionuclide Therapies: I for Benign and Malignant Disease, Parenteral Therapies – Patient Selection, Preparation, Evaluation,
Monitoring, and Follow-up — Patient Care 3
Level 1
Knows indications/
contraindications for
radioiodine therapy of
benign and malignant
thyroid diseases
Level 2
Evaluates, selects, and
prepares patients for
radioiodine therapy, including
obtaining consent, and
performs the procedure
Is familiar with radiation
Communicates radiation
safety precautions and
safety precautions to patient,
restrictions (e.g., isolation) family, caregivers, and
hospital personnel
Knows the indications/
contraindications for common
parenteral
radiopharmaceutical therapies
Comments:
Level 3
Selects and applies
appropriate patient release
criteria, and follows up with
patient after radioiodine
therapy
Evaluates, selects, and
prepares patients for
common parenteral
radiopharmaceutical
therapies, including obtaining
consent
Level 4
Plans and performs
radioiodine therapy in
complicated clinical situations
(e.g., renal failure, mentally
or physically challenged
patients)
Performs common parenteral
radiopharmaceutical
therapies
Level 5
Demonstrates knowledge of
emerging therapeutic
radiopharmaceuticals
Acts independently as a
consultant on
interdisciplinary teams
Teaches
radiopharmaceutical
therapy topics
Publishes or presents on a
radiopharmaceutical
therapy topic
Not yet achieved Level 1
“Common” and “uncommon” to be defined by each program
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3
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THE NUCLEAR RADIOLOGY MILESTONES: ACGME REPORT WORKSHEET
Anatomy, Physiology, and Pathophysiology — Medical Knowledge 1
Level 1
Knows normal planar and
cross-sectional anatomy
Recognizes common
anatomic variants and
commonly-encountered
pathology
Knows normal physiology
of adults and children
Understands
pathophysiology of
common diseases
Level 2
Understands physiologic
basis for patient preparation
protocols
Recognizes and explains
anatomic and functional
radiopharmaceutical imaging
findings of common diseases
in adults and children based
on knowledge of anatomy,
physiology, and
pathophysiology
Level 3
Recognizes and explains
correlative and hybrid
imaging findings of common
disease in adults and children
based on knowledge of
anatomy, physiology, and
pathophysiology
Level 4
Recognizes uncommon
anatomic variants
Recognizes and explains
radiopharmaceutical,
correlative, and hybrid
imaging findings of complex
and uncommon diseases in
adults and children based on
knowledge of anatomy,
physiology, and
pathophysiology
Level 5
Teaches planar and crosssectional anatomy,
physiology, and
pathophysiology
Understands physiologic
basis for pharmacologic
interventions and
subsequent imaging findings
Comments:
Not yet achieved Level 1
“Common” and “uncommon” to be defined by each program
Copyright (c) Pending. The Accreditation Council for Graduate Medical Education and the American Board of Radiology. All rights reserved. The
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4
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THE NUCLEAR RADIOLOGY MILESTONES: ACGME REPORT WORKSHEET
Physics and Instrumentation — Medical Knowledge 2
Level 1
Knows basic nuclear
radiology physics
Has knowledge of basic
instrumentation and
functions of non-imaging
devices (e.g., ionization
chambers, well counters,
survey meters, NaI probes)
and imaging devices (e.g.,
gamma cameras, positron
emission
tomography/computed
tomography (PET/CT)
scanners, and other hybrid
imaging systems)
Level 2
Understands the
mathematical principles of
the use and measurement of
radioactivity
Understands basic image
acquisition and image
processing
Recognizes common imaging
artifacts and technical
problems
Demonstrates knowledge of
routine instrument quality
control tests
Processes simple nuclear
radiology examinations (e.g.,
renal scan)
Comments:
Level 3
Understands how to optimize
image acquisition
Understands image
reconstruction methods
Level 4
Recognizes and resolves
common and uncommon
instrumentation artifacts
and other quality control
issues
Processes and optimizes
more complex nuclear
radiology examinations (e.g.,
multigated acquisition
cardiac)
Understands the
comparative advantages and
describes disadvantages of
routinely used nuclear
radiology instrumentation
Understands how to operate
a dose calibrator, survey
meter, and thyroid probe
Understands and describes
comparative advantages and
disadvantages of different
image reconstruction
methods
Recognizes common
abnormal quality control test
results
Level 5
Teaches nuclear radiology
physics and instrumentation
Presents or publishes physics
or instrumentation-related
research in peer-reviewed
media
Develops new quality control
and/or imaging protocols
Not yet achieved Level 1
“Common” and “uncommon” to be defined by each program
Copyright (c) Pending. The Accreditation Council for Graduate Medical Education and the American Board of Radiology. All rights reserved. The
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5
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THE NUCLEAR RADIOLOGY MILESTONES: ACGME REPORT WORKSHEET
Radiopharmaceuticals — Medical Knowledge 3
Level 1
Understands the tracer
principle
Knows the indications,
physical properties, and
expected biodistributions of
commonly used diagnostic
(e.g., Tc-99m) and therapeutic
(e.g., I-131)
radiopharmaceuticals
Level 2
Recognizes normal variant and
abnormal biodistributions of
commonly used diagnostic
and therapeutic
radiopharmaceuticals
Recognizes
radiopharmaceutical quality
control problems on images
(e.g., free 99mTc)
Knows basic radiopharmacy
operations and routine quality
control tests
Level 3
Knows the indications,
physical properties, and
expected biodistributions of
uncommonly used diagnostic
(e.g., In-111 pentetreotide)
and therapeutic (e.g., I-131
MIBG) radiopharmaceuticals
Recognizes normal variant
and abnormal
biodistributions of
uncommonly used diagnostic
and therapeutic
radiopharmaceuticals
Level 4
Discusses emerging
radiopharmaceuticals and
other molecular imaging
agents
Level 5
Teaches
radiopharmaceutical
topics, including quality
control
Resolves
radiopharmaceutical
quality control problems
Publishes or presents on a
radiopharmaceutical topic
Understands the elements
of a radiopharmaceutical
quality assurance program
Aids in the development of
new diagnostic and
therapeutic
radiopharmaceutical
protocols
Understands the implications
of radiopharmaceutical
quality control problems
Comments:
Not yet achieved Level 1
“Common” and “uncommon” to be defined by each program
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6
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THE NUCLEAR RADIOLOGY MILESTONES: ACGME REPORT WORKSHEET
Regulatory Requirements — Systems-based Practice 1
Level 1
Demonstrates awareness
of the Nuclear Regulatory
Commission (NRC),
pertinent state-specific
agencies, and methods of
accreditation
Knows the purpose and
functions of a nuclear
radiology radiation safety
program
Level 2
Knows the basic NRC
regulations and state-specific
laws applying to radioactive
materials use, storage, and
disposal, the definition of
Authorized User, and
components of a written
directive
Understands the composition
and function of the Radiation
Safety Committee and the
responsibilities of the
Radiation Safety Officer
Level 3
Applies appropriate laws and
regulations to daily clinical
scenarios in the nuclear
radiology clinic/laboratory
(e.g., receives packages,
performs ambient surveys)
Performs basic
radiopharmaceutical quality
control testing
Level 4
Understands the appropriate
rules and regulations
required to function as a
medical director of a nuclear
radiology unit
Is familiar with The Joint
Commission, NRC, and state
radiation safety inspection
processes
Level 5
Is capable of participating in
a regulatory committee,
such as the Radiation Use
Committee (RUC) or
Radiation Safety Committee
(RSC)
Serves as the point person
during an inspection by The
Joint Commission, NRC, or
state radiation safety
inspection team
Knows how to disclose
reportable or recordable
incidents
Comments:
Not yet achieved Level 1
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7
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THE NUCLEAR RADIOLOGY MILESTONES: ACGME REPORT WORKSHEET
Health Care Economics — Systems-based Practice 2
Level 1
Describes the technical and
professional components of
imaging costs in nuclear
radiology
Has a basic understanding of
the advantages and
disadvantages of different
payment systems
Comments:
Level 2
Demonstrates knowledge of
departmental cost-savings
initiatives
Creates reports that contain
the elements necessary to
support examination coding
and billing compliance
Level 3
Describes billing and coding
problems of specific nuclear
radiology examinations and
procedures; recognizes and
corrects incorrect coding
Level 4
Understands the concept of
national quality improvement
financial incentives (e.g.,
Physician Quality Reporting
System [PQRS])
Develops understanding of
relative charges and
reimbursement for common
nuclear radiology
examinations and
procedures
Knows the current
reimbursement rules for highcost complex nuclear
radiology procedures (e.g.,
flurodeoxyglucose [FDG],
PET/CT, hybrid imaging)
Has a basic understanding
of the pre-certification
process, radiology benefits
managers, and structured
computer-based order entry
systems
Has an advanced practical
understanding of the precertification process, radiology
benefits managers, and
structured computer-based
order entry systems
Level 5
Has a basic understanding
of current state and
national health care
policies and their
implications
Not yet achieved Level 1
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THE NUCLEAR RADIOLOGY MILESTONES: ACGME REPORT WORKSHEET
Quality Improvement — Systems-based Practice 3
Level 1
Describes the departmental
incident/occurrence
reporting system
Level 2
Describes nuclear radiology
quality improvement
initiatives
Participates in the
departmental
incident/occurrence
reporting system
Comments:
Level 3
Incorporates nuclear
radiology quality
improvement into clinical
practice
Works in inter-professional
teams to enhance patient
safety and improve patient
care quality
Level 4
Participates in identifying
institutional operational gaps
and implementing potential
solutions
Level 5
Leads a team in the design
and implementation of a
quality improvement
project for the nuclear
radiology program
Routinely participates in
institutional root cause
analysis
Not yet achieved Level 1
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9
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THE NUCLEAR RADIOLOGY MILESTONES: ACGME REPORT WORKSHEET
Self-directed Learning — Practice-based Learning and Improvement 1
Level 1
Is aware of gaps in personal
knowledge and experience;
seeks help when
appropriate
Incorporates feedback
from teachers, colleagues,
and patients for selfimprovement
Develops a personal
learning plan
Level 2
Seeks and incorporates
feedback to improve
performance
Level 3
Demonstrates a balanced and
accurate professional selfassessment
Level 4
Develops an ongoing
personal continuing
education plan
Level 5
Participates in a lifelong
continuing education plan in
the subspecialty
Assesses and provides
feedback to junior learners
Investigates clinical
outcomes, and identifies
areas for continued
improvement
Regularly incorporates
evidence-based information
and current research into
self-directed learning
Develops an educational
curriculum and/or
assessment tools (e.g.,
resident evaluation tool)
Shows evidence of reading
current literature related to
clinical topics
Prepares and teaches
residents/student
conferences
Selects evidence-based
information to answer
advanced clinical questions
Selects evidence-based
information to answer
basic clinical questions
Comments:
Not yet achieved Level 1
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10
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THE NUCLEAR RADIOLOGY MILESTONES: ACGME REPORT WORKSHEET
Scholarly Activity — Practice-based Learning and Improvement 2
Level 1
Demonstrates
understanding of critical
thinking skills and research
design (e.g., journal club)
Demonstrates knowledge of
basic principles underlying
the ethical conduct of
research and the protection
of human subjects
Level 2
Critically reviews and
interprets the literature,
demonstrating the ability to
identify study aims,
hypotheses, design, and
biases
Initiates a focused scholarly
activity
Level 3
Applies the principles of
ethics and good clinical
practice to the protection of
human subjects recruited to
participate in research
Maintains data safety and
patient monitoring to ensure
continued protection of
human subjects
Level 4
Demonstrates
understanding of statistics
and epidemiology in data
analysis
Completes and presents
scholarly activity to peers
for review and critique at
the departmental or
local/regional/national
level
Level 5
Independently plans and
executes research project
Applies for/obtains
extramural funding for
research study
Submits research to peerreviewed journal and/or
presents nationally
Identifies a mentor and
proposes a scholarly activity
Comments:
Not yet achieved Level 1
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Version 2/2014
Individual — Professionalism 1
Level 1
Is an effective health care team
member, promoting primacy of
patient welfare, patient
autonomy, and social justice
THE NUCLEAR RADIOLOGY MILESTONES: ACGME REPORT WORKSHEET
Level 2
Seeks and incorporates
feedback to improve
professional behavior
Level 3
Discusses individual
professionalism issues
with students and
residents
Level 4
Serves as a role model for
individual professional
behavior
Level 5
Mentors others regarding
professionalism and ethics
Demonstrates the following
professional behaviors:
 is truthful
 recognizes personal
limitations and seeks help
when appropriate
 recognizes personal
impairment and seeks help
when needed
 responds appropriately to
constructive criticism
 places needs of patients
before self
 maintains appropriate
boundaries with patients,
colleagues, and others
 exhibits tolerance and
acceptance of diverse
individuals and groups
Comments:
Levels 2-4: Maintains professional behavior as described in Level 1
Not yet achieved Level 1
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12
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Systems — Professionalism 2
Level 1
Is an effective health care team
member who demonstrates the
following professional
behaviors:
 fulfills work-related
responsibilities
 recognizes the importance
and priority of patient care
and advocates for patient
interests
 maintains patient
confidentiality
 fulfills Institutional and
Program Requirements
related to professionalism
and ethics
 prepares for and attends
required conferences
THE NUCLEAR RADIOLOGY MILESTONES: ACGME REPORT WORKSHEET
Level 2
Identifies opportunities to
improve professionalism in
the workplace
Level 3
Takes part in programs to
improve clinical care and
professional behavior
Discusses system
professionalism issues with
students and residents
Comments:
Levels 2-4: Maintains professional behavior as described in Level 1
Level 4
Serves as a role model for
system professionalism
Is an effective health care
team leader
Level 5
Accepts leadership roles in
institutional, regional, and/or
national organizations to
advance professionalism
Not yet achieved Level 1
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13
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THE NUCLEAR RADIOLOGY MILESTONES: ACGME REPORT WORKSHEET
Effective Communication with Patients, Families, and Caregivers — Interpersonal and Communication Skills 1
Level 1
Adheres to HIPAA and
institutional confidentiality
policies
Exhibits basic
communication skills and,
with indirect supervision,
can effectively
communicate in nonstressful situations (e.g.,
normal results, acquiring
patient history)
Obtains informed consent
for diagnostic procedures
(e.g., pregnant patient,
sentinel node injections)
Comments:
Level 2
Communicates more
complex or difficult
information (e.g., abnormal
results, need for additional
imaging) in straightforward
cases
Communicates with more
challenging patients (e.g.,
cognitive impairment,
anxiety, cultural differences,
language barriers, low health
literacy) under indirect
supervision
Level 3
Working with program faculty
members, oversees and
teaches more junior learners
on how to communicate
effectively with patients,
families, caregivers, and staff
members
Under direct supervision,
obtains informed consent for
therapeutic procedures
Level 4
Serves as a role model for
effective and compassionate
communication for more
junior learners
Level 5
Develops guidelines for
communication within the
department or institution
Seeks leadership
opportunities in regional or
national professional
organizations with regards
to patient-centered
communication
Seeks leadership
opportunities in the
department or institution
with regards to patientcentered communication
Under direct supervision,
communicates medical
errors, complications, and
adverse events
Communicates medical
errors, complications, and
adverse events
Under indirect supervision,
obtains informed consent for
therapeutic procedures
Not yet achieved Level 1
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THE NUCLEAR RADIOLOGY MILESTONES: ACGME REPORT WORKSHEET
Effective Communication with Members of the Health Care Team (Written and Oral) — Interpersonal and Communication Skills 2
Level 1
Adheres to HIPAA and
institutional confidentiality
policies
Efficiently generates clear,
accurate, and concise
reports that do not need
substantial faculty member
corrections in most cases
Communicates effectively
and professionally in nonstressful situations
Understands the
institutional policy for
transitions of care and
hand-offs/hand-overs
Communicates urgent,
critical, and unexpected
findings according to
institutional policy, and in
compliance with ACR
guidelines
Comments:
Level 2
Efficiently generates clear,
accurate, and concise reports
that do not need substantial
faculty member corrections
in all cases
Communicates effectively
and professionally during
more stressful situations
(e.g., on call, busy day)
Effectively manages
transitions of care and handoffs/hand-overs
Level 3
Generates tailored reports
meeting the specific needs of
the referring providers
Level 4
Serves as a role model for
effective professional
communication
Communicates effectively
and professionally in all
situations (e.g., during
interpersonal or
interdisciplinary conflicts)
With faculty member
supervision, helps to
organize departmental and
interdisciplinary teaching
and/or patient care
conferences
Works with program faculty
members to oversee and
teach junior learners on how
to communicate effectively
and professionally
Actively participates in
departmental and
interdisciplinary teaching
and/or patient care
conferences
Seeks leadership
opportunities in the
department or institution
with regards to health care
team-centered
communication
Level 5
Develops and implements
standardized report templates
Resolves service issues
effectively and professionally
(e.g., delay in exam
scheduling)
Independently leads
departmental and
interdisciplinary teaching
and/or patient care
conferences
Develops guidelines for
written and oral
communications for local or
national use
Seeks leadership
opportunities in regional or
national professional
organizations with regards to
health care team-centered
communication
Not yet achieved Level 1
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