The University of Minnesota Medical School organizes its competencies into nine domains of knowledge, skills and attitudes. These domains and competencies are adapted from the AAMCs Physician Competency Reference Set and align with the core ACGME competencies. This alignment will promote continuity of learning and assessment from medical school to residency and beyond. Demonstration of proficiency in each of these competencies is a requirement of graduation.
The nine domains represent the highest, broadest tier of the hierarchical structure used to organize curricular priorities. Each step below the top domain level narrows in scope:
I. Domains of competence
A. Subject-related competencies
1. Course goals
a. Session objectives
The domains and their competencies are illustrated below. Course and session objectives, too numerous to display here, are mapped to competencies and domains in an interactive tool available to students, faculty and staff.
The building blocks of our medical education programs are specific, measurable learning objectives. These objectives are categorized under the more broadly defined competencies. The competencies, in turn, roll up under the umbrella of the nine domains of competence. Collectively, these three tiers represent the building blocks of the competency-driven learning strategy.
The Nine Domains and Their Associated Competencies
Provide patient-centered care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.
- Perform all medical, diagnostic, and surgical procedures considered.
- Gather essential and accurate information about patients and their conditions through history-taking, physical examination, and the use of laboratory data, imaging, and other tests.
- Organize and prioritize responsibilities to provide care that is safe, effective, and efficient.
- Interpret laboratory data, imaging studies, and other tests required for the area of practice.
- Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment.
- Develop and carry out patient management plans.
- Counsel and educate patients and their families to empower them to participate in their care and enable shared decision making.
- Provide appropriate referral of patients including ensuring continuity of care throughout transitions between providers or settings, and following up on patient progress and outcomes.
- Provide health care services to patients, families, and communities aimed at preventing health problems or maintaining health.
- Provide appropriate role modeling.
- Perform supervisory responsibilities commensurate with one's roles, abilities, and qualifications.
Knowledge for Practice
Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care.
- Demonstrate an investigatory and analytic approach to clinical situations.
- Apply established and emerging bio-physical scientific principles fundamental to health care for patients and populations.
- 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.
- 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.
- Apply principles of social-behavioral sciences to provision of patient care, including assessment of the impact of psychosocial and cultural influences on health, disease, care-seeking, care compliance, and barriers to and attitudes toward care.
- Contribute to the creation, dissemination, application, and translation of new health care knowledge and practices.
Practice-Based Learning and Improvement
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.
- Identify strengths, deficiencies, and limits in one's knowledge and expertise.
- Set learning and improvement goals.
- Identify and perform learning activities that address one's gaps in knowledge, skills, and/or attitudes.
- Systematically analyze practice using quality improvement methods, and implement changes with the goal of practice improvement.
- Incorporate feedback into daily practice.
- Locate, appraise, and assimilate evidence from scientific studies related to patients' health problems.
- Use information technology to optimize learning.
- Participate in the education of patients, families, students, trainees, peers and other health professionals.
- Obtain and utilize information about individual patients, populations of patients, or communities from which patients are drawn to improve care.
- Continually identify, analyze, and implement new knowledge, guidelines, standards, technologies, products, or services that have been demonstrated to improve outcomes.
Interpersonal and Communication Skills
Demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals.
- Communicate effectively with patients, families, and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds.
- Communicate effectively with colleagues within one's profession or specialty, other health professionals, and health related agencies (see also Interprofessional Collaboration #3).
- Work effectively with others as a member or leader of a health care team or other professional group (see also Interprofessional Collaboration #4).
- Act in a consultative role to other health professionals.
- Maintain comprehensive, timely, and legible medical records.
- Demonstrate sensitivity, honesty, and compassion in difficult conversations, including those about death, end of life, adverse events, bad news, disclosure of errors, and other sensitive topics.
- Demonstrate insight and understanding about emotions and human responses to emotions that allow one to develop and manage interpersonal interactions.
Demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles.
- Demonstrate compassion, integrity, and respect for others.
- Demonstrate responsiveness to patient needs that supersedes self-interest.
- Demonstrate respect for patient privacy and autonomy.
- Demonstrate accountability to patients, society, and the profession.
- Demonstrate sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation.
- 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.
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.
- Work effectively in various health care delivery settings and systems relevant to one's clinical specialty.
- Coordinate patient care within the health care system relevant to one's clinical specialty.
- Incorporate considerations of cost awareness and risk-benefit analysis in patient and/or population-based care.
- Advocate for quality patient care and optimal patient care systems.
- Participate in identifying system errors and implementing potential systems solutions.
- Perform administrative and practice management responsibilities commensurate with one’s role, abilities, and qualifications.
Demonstrate the ability to engage in an interprofessional team in a manner that optimizes safe, effective patient- and population-centered care.
- Work with other health professionals to establish and maintain a climate of mutual respect, dignity, diversity, ethical integrity, and trust.
- Use the knowledge of one’s own role and the roles of other health professionals to appropriately assess and address the health care needs of the patients and populations served.
- 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.
- Participate in different team roles to establish, develop, and continuously enhance interprofessional teams to provide patient- and population-centered care that is safe, timely, efficient, effective, and equitable.
Personal and Professional Development
Demonstrate the qualities required to sustain lifelong personal and professional growth.
- Develop the ability to use self-awareness of knowledge, skills, and emotional limitations to engage in appropriate help-seeking behaviors.
- Demonstrate healthy coping mechanisms to respond to stress.
- Manage conflict between personal and professional responsibilities.
- Practice flexibility and maturity in adjusting to change with the capacity to alter one's behavior.
- Demonstrate trustworthiness that makes colleagues feel secure when one is responsible for the care of patients.
- Provide leadership skills that enhance team functioning, the learning environment, and/or the health care delivery system.
- Demonstrate self-confidence that puts patients, families, and members of the health care team at ease.
- Recognize that ambiguity is part of clinical health care and respond by utilizing appropriate resources in dealing with uncertainty.
Scientific and Clinical Inquiry
Demonstrate understanding of scientific theory and methodology and the critical thinking skills needed to interpret and apply research to improving patient care.
- Demonstrate understanding of the ethical, legal, professional and social issues implicit in the responsible design and conduct of research.
- Demonstrate the critical thinking skills needed for applying basic and clinical research to improving patient care.
Adapted from the AAMC's Physician Competencies Reference Set (PCRS)
Approved by the Education Council – March 2015