Evaluating systems-based practice in emergency medicine

The Accreditation Council for Graduate Medical Education has required that training programs initiate an evaluation process to assess resident acquisition of the newly promulgated general competencies (GCs). Certain GCs (e.g., systems-based practice, problem-based learning and improvement) are somewhat more challenging to define and measure than others. Systems-based practice essentially captures the interactions of the emergency medicine resident that expand beyond isolated contact with the patient. Evaluating these various interactions is readily accomplished using a detailed ordinal evaluation form that measures commonly occurring easily identified actions. Examples of measurable items and the method by which they can be integrated into an evaluation device are presented.