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Developing a cultural consensus analysis (CCA) based on the internal medicine milestones.


Smith CS. — University of Washington, Seattle, WA

Hill W, Francovich C, Morris M. — VA Medical Center, Boise, ID

Caverzagie K. — Henry Ford Medical Group

Iobst W. — American Board of Internal Medicine

Presented: Association of Medical Education in Europe Conference, September 2010

Background: A national task force identified domains and developmental milestones from the national competencies for resident training. Cultural Consensus Analysis (CCA) is a standard anthropological technique that identifies value conflicts.

Summary of Work: 1) Convert the 39 milestone domains into active statements; 2) Reduce the total number to 12 by summarizing and combining; 3) Simplify these statements; and 4) Check the initial face validity.

Summary of Results: CCA statements: Care for patients by ordering tests and procedures correctly. Care for patients with different diseases in the clinic, nursing home and hospital. Know how to read basic labs and x-rays, and use medications. Know how to handle patients with different diseases. Listen to feedback, work to find weaknesses and try to improve. Find and analyze new studies to help patient care. Talk clearly with patients, families, doctors, staff and outside groups. Keep timely, complete and clear chart notes. Show caring and respect for patients and others. Show respect for society and the medical profession. Work with the team to get quality patient care and make the best system. Think of cost and risk when making decisions.

Conclusions/Take-Home Messages: A set of milestone CCA statements exists. It can be used to test receptivity to milestones and validate the six residency competency models.

For more information about this presentation, please contact Research@abim.org.