The SOAP Approach Aims to Conquer the ACGME Competencies Challenge

Debra A. DaRosa, PhD
Professor and Vice-Chair of Education
Feinberg School of Medicine
Northwestern University

Members of the AAMC-Group on Educational Affairs (GEA) have developed two programs that use a "train the trainers" approach designed to enhance faculty and residency program directors' abilities to effectively and efficiently address and assess the ACGME's six core competencies. Each of the two programs or modules utilizes the acronym "SOAP" to guide faculty through the steps necessary to integrate the six core competencies into their programs. SOAP stands for:

S = Study current RRC language as well as teaching/assessment measures relative to the ACGME competencies;

O = Objectify the assessment process by adapting/adopting available measures or creating new measures;

A = Audit and revise the assessment system based on psychometric analysis;

P = Plan for accommodating the competencies by ensuring an appropriate administrative infrastructure as well as resource access.

Each of the two modules utilizes this modified SOAP format to teach about designing competency-based education, but each module differs in length and purpose. It is understood that many residency programs have already developed curriculum and evaluation methods to meet the ACGME competency requirements. The two modules can be used by programs that have not yet formally completed this effort, or would like to enhance their competency curriculum and corresponding evaluation systems.

Module One

Module One is intended for a faculty audience, which can include new faculty or seasoned faculty who need to be made aware of the competency requirements. Module One is designed as a general overview of an approach to comprehending the ACGME competencies. It can be used in multiple forums (ie: Grand Rounds, noon conference, faculty meeting, small group discussions, or keynote address) for any audience involved in graduate medical education. It is assumed that the instructor of this module will have a clear understanding of the ACGME Outcomes Project (Competencies Requirements). Module One includes a slide presentation, speaker notes, and general references. The speaker notes section corresponds to the slides and was written to provide the speaker with appropriate transition statements, as well as guidelines on key points to emphasize. The notes were not written to explain the information on the slides since it is assumed the speaker understands the content. Like the slides, the speaker notes section may be modified to meet the instructor's needs as seen fit. Users should feel free to choose among the provided slides based on their preferences on what to include/exclude.

Module One objectives enable participants to:

1. Describe the development of, and rationale for, the ACGME Outcomes Project;
2. Explain the major components of the SOAP approach as a response to the competencies challenge.

Module One does not include copies of the PowerPoint slides as a handout to afford flexibility to individual instructors who may not choose to use all of the provided slides. Therefore, if the instructor wants to distribute the slides as handouts to the audience, he or she will need to print them out.

Module Two

This module is designed for program directors or other faculty members responsible for planning the teaching and evaluation of the ACGME competencies. It can be used by a program director to work through curriculum and evaluation efforts relevant to the competencies, or by GME deans needing to guide program directors at their institution. It is assumed that the instructor of this module will also have a clear understanding of the ACGME Outcomes Project and basic principles of measurement.

Module Two includes a slide presentation, worksheets, speaker notes, and references. Instructors should feel free to adapt the provided materials to their style and preferences. The speaker notes section suggests transition statements and areas typically needing clarification or emphasis.

The objectives of Module Two are to enable participants to:

1. Describe the development of, and rationale for, the ACGME Outcomes Project;
2. Utilize the modified SOAP approach to respond to the competencies challenge;
3. Apply a blueprinting process to documenting teaching and assessment plans specific to the ACGME competencies.

Since a video clip is included, a computer projector with speakers and a sound card/ connection or stand-alone speaker system to be connected to the computer is needed. If these resources are not available, then the video clip should be deleted. Please note that the video clip is a freestanding file on the CD. Therefore, users will need to save the video clip to their hard drive and then link the video file to play with the PowerPoint presentation (specific to the computer being used). It sounds complicated...but it isn't.

Developers

The two modules and corresponding materials were developed by Deborah Simpson, PhD, Medical College of Wisconsin; Debra A. DaRosa, PhD, Northwestern University; and Linda Perkowski, PhD, University of Texas Health Science Medical Center at Houston.

Acknowledgements

The project was sponsored by the Group on Educational Affairs of the Association of American Medical Colleges. Acknowledgement is warranted to the following organizations and medical schools/universities that share the goal of improving the quality of care for patients through medical education and graciously provided selected examples, materials, and support utilized in this program:

• Accreditation Council on Graduate Medical Education
• American Board of Internal Medicine
• Association of American Medical Colleges
• Medical College of Wisconsin
• Wisconsin Geriatric Education Center
• Northwestern University Feinberg School of Medicine
• Southern Illinois University School of Medicine

How to Order

The modules are on one CD and are $5. The CD can be purchased through the Educational Clearinghouse of the Association for Surgical Education by e-mail at http://www.surgicaleducation.com or by calling 217-545-3835. This is a not-for-profit program, and no royalties are collected by the authors.