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    • THE RESIDENCY REVIEW COMMITTEE FOR PEDIATRICS 515 N State, Ste 2000, Chicago, IL 60610 • (312) 755-5000 • www.acgme.org CONTINUED ACCREDITATION ONLY – PEDIATRIC CARDIOLOGY GENERAL INSTRUCTIONS REVIEW OF AN ACCREDITED PROGRAM OR RE-ACCREDITATION OF A PROGRAM: If the Program Information Form (PIF) is being completed for a currently accredited program, follow the provided instructions to create the correct form. Go to the Accreditation Data System found on the ACGME home page (www.acgme.org) under Data Collection Systems. Using your previously assigned User ID and password, proceed to the PIF Preparation section on the left hand menu and update the Common PIF data. Most data are updated through annual updates, but some information is required at the time of site visit only. Once the data entry is complete, select Generate PIF to review and print the Common PIF (PDF). Pages will be numbered consecutively in the bottom center of each page. Once the Common PIF is complete, proceed to the appropriate Residency Review Committee webpage to retrieve the Specialty Specific PIF for CONTINUED ACCREDITATION. Once the forms are complete, enter page numbers for the Continued PIF in the bottom center for each page that consecutively follows the Common PIF numbering, combine the Common PIF and the Continued Accreditation PIF and complete the Table of Contents (found with the Specialty Specific PIF instructions). After completing the PIF/documents, make four copies. They must be identical and final. Draft copies are not acceptable. The forms should be submitted bound by either sturdy rubber bands or binder clips. Do not place the forms in covers such as two or three ring binders, spiral bound notebooks, or any other form of binding. Mail one set of the completed forms to the site visitor at least 14 working days before the site visit. The remaining three sets should be provided to the site visitor on the day of the visit. The program director is responsible for the accuracy of the information supplied in this form and must sign it. It must also be signed by the designated institutional official of the sponsoring institution. Review the Program Requirements for Residency Education in Pediatric-Cardiology. The Program Requirements or the Institutional Requirements may be downloaded from the ACGME Website (www.acgme.org): For word processing questions/problems regarding: -the completion of the form (content), contact the Accreditation Administrator. -the Accreditation Data System, email WebADS@acgme.org. For a glossary of terms, use the following link – http://www.acgme.org/acWebsite/GME_info/gme_glossary.asp SPECIALTY SPECIFIC INSTRUCTIONS A pediatric subspecialty program must function in conjunction with an accredited program in pediatrics that is in good standing. The title of the program should correspond to the title of the affiliated pediatrics program. All program titles are subject to editing to conform to ACGME policies. Identify as the SPONSORING INSTITUTION that entity that assumes ultimate responsibility for the program, as evidenced by the fact that it monitors the quality of the education and coordinates accreditation activity. There may only be one sponsor and it must be the same sponsor as the sponsor for the core residency program. Refer to the ACGME Institutional Requirements. Pediatric Cardiology Continued Accreditation PIF 1
    • If the SPONSORING INSTITUTION and the PRIMARY SITE are one and the same, the site’s name should be entered in the section requesting NAME AND ADDRESS OF SPONSORING INSTITUTION and in the section requesting PRIMARY SITE. All sites offering required rotations or experiences should be listed. One site should be designated as the PRIMARY SITE and identified as Site #1. Pediatric Cardiology Continued Accreditation PIF 2
    • Please have the following documents available for the site visitor: 1. Overall educational goals for the program 2. Written competency-based goals and objectives for each experience at each educational level (if your Review Committees wishes to see a sample, it will request one to be appended to the PIF) 3. Current Program Letters of Agreement (PLAs) 4. Files for current residents/fellows and most recent program graduates 5. Files of residents/fellows who have transferred into the program (if applicable), including documentation of previous experience and competency-based performance evaluation 6. Program Policy Manual, including: a) policies for resident appointment, eligibility, selection, and promotion b) policies for supervision of residents c) policies and procedures for resident duty hours and the working environment d) moonlighting policy 7. Institutional policy for remediation and dismissal of residents, including due process. 8. Documentation of resident evaluation including: a) Resident evaluation at the end of each rotation or similar educational experience b) Written or electronic semiannual evaluation of the resident with feedback c) A final (summative) evaluation for each resident that documents the resident’s performance during the final period of education and verifies that the resident has demonstrated sufficient competence to enter practice without direct supervision (files for the most recent year’s graduates for review by the site visitor) 9. Completed evaluations of the faculty by the residents 10. Completed evaluations of the program by the residents 11. The written improvement action plan the program prepared after a review of the aggregated results of residents’ performance and/or other program evaluation results 12. Documentation of resident duty hours 13. Documentation of internal review (date, participants’ names and titles, type of data collected, when reviewed by the GMEC) 14. The resident supervision policy that addresses the following: a) Residents’ responsibilities for patient care b) Progressive responsibility for patient management c) Supervision of patient care 15. or single-program institution (e.g., an institution that sponsors just one accredited program) or an institution with multiple residencies accredited by the same Review Committee: A copy of the resident contract/agreement with the items required by the ACGME numbered according to Institutional Requirement II.D.) Pediatric Cardiology Continued Accreditation PIF 3
    • SPECIALTY SPECIFIC INSTRUCTIONS A pediatric subspecialty program must function in conjunction with an accredited program in pediatrics that is in good standing. The title of the program should correspond to the title of the affiliated pediatrics program. All program titles are subject to editing to conform to ACGME policies. Identify as the SPONSORING INSTITUTION that entity that assumes ultimate responsibility for the program, as evidenced by the fact that it monitors the quality of the education and coordinates accreditation activity. There may only be one sponsor and it must be the same sponsor as the sponsor for the core residency program. Refer to the ACGME Institutional Requirements. If the SPONSORING INSTITUTION and the PRIMARY SITE are one and the same, the site’s name should be entered in the section requesting NAME AND ADDRESS OF SPONSORING INSTITUTION and in the section requesting PRIMARY SITE. All sites offering required rotations or experiences should be listed. One site should be designated as the PRIMARY SITE and identified as Site #1. Pediatric Cardiology Continued Accreditation PIF 4
    • THE RESIDENCY REVIEW COMMITTEE FOR PEDIATRICS 515 N State, Ste 2000, Chicago, IL 60610 • (312) 755-5000 • www.acgme.org 10 Digit ACGME Program I.D. #: Program Name: TABLE OF CONTENTS When you have the completed forms, number each page sequentially in the bottom right hand corner. Report this pagination in the Table of Contents and submit this cover page with the completed PIF. Common PIF1 Page(s) Accreditation Information Participating Sites Sponsoring Institution/Single or Limited Residency Institution (If applicable) Faculty/Teaching Staff Program Director Information Physician Faculty Roster Faculty Curriculum Vitae Non Physician Faculty Roster Resident Appointments Number of Positions Actively Enrolled Residents (if applicable) Aggregated Data on Residents Completing or Leaving the Program for the last 3 years (if applicable) Residents Completing Program in the Last 3 years (if applicable) Transferred, Withdrawn, and Dismissed Residents (if applicable) Evaluation Resident Duty Hours Pediatric Subspecialty PIF Page(s) Faculty Research Research Resources Program Curriculum Block Diagram Goals and Objectives Collaboration Between Programs General Subspecialty Curriculum Conferences Scholarship Oversight Committee Fellow Research Activities Pediatric Cardiology Continued Accreditation PIF 5
    • Specialty Specific PIF Page(s) Other Professional Personnel Resources: Facilities and Services Inpatient Service/Outpatient Services Support Facilities Patient Care Patient Data Ambulatory Pediatric Cardiology Experience for All Years of Training List of Diagnoses Pediatric Cardiology Surgical Statistics Pediatric Cardiac Catheterization Statistics Pediatric Procedures Fellow Procedures Medical Knowledge Inpatient Experiences Outpatient Experiences Practice-based Learning and Improvement Interpersonal and Communication Skills Professionalism Systems-based Practice Appendix A – Goals and Objectives Pediatric Cardiology Continued Accreditation PIF 6
    • RESIDENCY REVIEW COMMITTEE FOR PEDIATRICS 515 N State, Ste 2000, Chicago, IL 60610 • (312) 755-5000 • www.acgme.org COMMON SUBSPECIALTY PROGRAM INFORMATION FORM FACULTY RESEARCH 1. Complete the table below regarding the involvement of faculty in research. Add rows as necessary. # of current # of current research projects # presentations IRB Total # of with peer review at national # publications approved current funded funding (subset of scientific in peer review research research total # in previous meetings in the journals in the projects projects column) last 5 years last 5 years Program Director: Key Faculty: Mentors Who Are Not Key Faculty: 2. List active research projects in the subspecialty. Put an “X for funding awarded Years of Faculty investigator and by peer review funding role in grant (i.e. PI, Co-PI, Project title Funding source process (dates) Co-investigator) Pediatric Cardiology Continued Accreditation PIF 7
    • 3. To enable the Committee to assess the scholarly environment of the program, provide a list of scholarly publications and presentations at regional, national and international meetings by faculty and fellows within the program for the last five years only. Do not duplicate citations. Underline the names of subspecialty fellows. List journal articles and presentations (abstracts, workshops, invited talks) separately under those headings. RESEARCH RESOURCES 1. Does the program provide research laboratory space and equipment? (if appropriate) ..............................................................................................................................( ) YES ( ) NO 2. Does the program provide financial support for research?....................................( ) YES ( ) NO 3. Does the program provide computer and statistical consultation services?...........( ) YES ( ) NO Pediatric Cardiology Continued Accreditation PIF 8
    • PROGRAM CURRICULUM 1. Block Diagram The purpose of a block diagram is to give the Residency Review Committee an overview of what takes place during each year of training. EXPERIENCES OF ROTATIONS • In each one month or 4 week block indicate the following: (1) the learning activity (i.e., Trauma) or vacation, (2) percentage of clinical (C) and research (R) time (i.e., 50% C; 50% R) (3) the site in which the activity occurs (i.e., HOSP1, HOSP 2 or OTHER – clinical site or office) as designated in Section 2 of this form. • Provide a key/legend for the abbreviations used (i.e., ED = Emergency Department), DUTY HOURS • In the row requesting duty hours, report (1) the usual number of hours/week worked and (2) the longest consecutive hours during that week. • Indicate whether call is call from home (H) or in-house call (IH). • Asterisk the rotations that are call free. Example Month/4wk 1 2 3 4 5 6 7 8 9 10 11 12 13 ED ED Trauma ELEC ELEC ELEC Research ED Anes Research Research Experience or 100% 100% 100% 100% 100% 100% 20% (C) 100% (C) 100% (C) 100% (R) 100% (R) VAC N/A rotations (C) (C) (C) (C) (C) (C) 80% (R) HOSP1 HOSP1 HOSP2 HOSP1 HOSP1 HOSP1 HOSP2 HOSP1 HOSP1 HOSP2 HOSP1 70/20 70/10 70/10 80/24 85/30 70/30 70/30 80/30 Duty Hours 60/20 * 60 * 60 * IH IH IH IH IH IH IH H Pediatric Cardiology Continued Accreditation PIF 9
    • FIRST YEAR BLOCK DIAGRAM Month/4wk 1 2 3 4 5 6 7 8 9 10 11 12 13 Experience or rotations Duty Hours SECOND YEAR BLOCK DIAGRAM Month/4wk 1 2 3 4 5 6 7 8 9 10 11 12 13 Experience or rotations Duty Hours THIRD YEAR BLOCK DIAGRAM Month/4wk 1 2 3 4 5 6 7 8 9 10 11 12 13 Experience or rotations Duty Hours Total number of clinical months _____________ Total number of research months ____________ If there are any exceptions to the fellowship program as outlined above for any of the current fellows, describe these exceptions below (Insert text in box.): Limit response to 50 words Pediatric Cardiology Continued Accreditation PIF 10
    • 2. Goals and Objectives A complete set of goals and objectives must be available for the site visitor. Choose as a sample the goals and objectives for one clinical rotation and attach it to the PIF as Appendix A (do not append all of the goals and objectives). For new applications, submit the complete set of goals and objectives. Place an ‘X” in the box before the applicable response. Are there goals and objectives for all training ( ) YES ( ) NO experiences? Are they rotation and level specific? ( ) YES ( ) NO How are they distributed? ( ) Hard Copy ( ) Electronic or web-based If not web-based, when are they distributed to ( ) Prior to Each Rotation ( ) Annually fellows? ( ) Once in Handbook ( ) Other ( ) Prior to Each Rotation If not web-based, when are they distributed to ( ) Annually faculty? ( ) Other If web-based, do you send out reminders to access ( ) YES ( ) NO them? If yes, when do you send them? 3. Collaboration between Programs Are there meetings among the core Program ( ) YES ( ) NO Director and subspecialty Program Directors? If yes, have minutes available for site visitor confirmation How often do these meetings occur? Who is typically involved in these meetings? ( ) Core program director (check all that apply) ( ) Subspecialty program director for this specialty ( ) Program directors from other subspecialties Pediatric Cardiology Continued Accreditation PIF 11
    • 4. General Subspecialty Curriculum Participants (place and X in the appropriate Where Taught in Number of column) Curriculum? Structured Fellows in All Residents & (Name should Teaching Hours this Subspecialty Subspecialty match name in Dedicated to Topic Discipline Fellows Fellows Topic conference list) Area? Attend Attend Attend e.g., Biostatistics Research Course 14 X Basic science as related to the application in clinical subspecialty practice Clinical subspecialty content For the topics below, if the topic is not appropriate for your discipline (i.e., lab research for fellows in developmental and behavioral pediatrics), enter N/A into column 1. Biostatistics Lab research methodology (if appropriate) Clinical research methodology Study design Grant preparation Preparation of protocols for institutional review board Principles of evidence- based medicine/ Critical literature review Quality Improvement Teaching skills Professionalism/Ethics Cultural Diversity Systems-based practice (economics of healthcare, practice management, clinical outcomes, etc.) Pediatric Cardiology Continued Accreditation PIF 12
    • 5. Conferences Have Conference Schedule Available For Review By Site Visitor. Do Not Append Conference Schedule. a) List regular subspecialty and interdepartmental conferences, rounds, etc., that are a part of the subspecialty training program. Identify the "SITE" by using the corresponding number as appears on the first and second pages of this form. Indicate the frequency, e.g., weekly, monthly, etc., and whether conference attendance is required (R) or optional (0). List the role of the fellow in this activity. (e.g., conducts conference, presents case and participates in discussion, case presentation only, participation limited to Q&A component, etc.) Conference Site # Frequency R/O Role of the Fellow b) Describe the mechanism that is used to assure fellow attendance at required conferences. State the degree to which faculty attendance is expected, and how this is monitored. Limit response to 50 words 6. Scholarship Oversight Committee a) Is there a scholarship oversight committee for every fellow?........................( ) YES ( ) NO If yes, have names of committee members for each fellow available for site visitor confirmation. b) How often does the committee meet with the fellow?...............................# ( ) times per year c) Are there written guidelines outlining the responsibility of the oversight committee? If yes, have the guidelines available for site visitor confirmation...................( ) YES ( ) NO 7. Fellow Research Activities a) Describe how the program ensures a meaningful supervised research experience for the fellows, beginning in their first year and extending throughout their training. b) If faculty outside the division are actively involved in mentoring the fellows, list and provide details. Pediatric Cardiology Continued Accreditation PIF 13
    • RESIDENCY REVIEW COMMITTEE FOR PEDIATRICS 515 N State, Ste 2000, Chicago, IL 60610 • (312) 755-5000 • www.acgme.org PROGRAM INFORMATION FORM - PEDIATRIC CARDIOLOGY PERSONNEL, FACILITIES AND SERVICES A. Other Professional Personnel 1. List the clinical setting/experience and, for each, indicate with a check mark the personnel who interact regularly with fellows. Team Members PAs working Nurse Mid-Level with Specialists Practitioners cardiologists, trained in (eg: clinical cardiovascular pediatric nurse Cardiovascular surgeons or the Catheterization/ cardiovascular practitioners Social Surgery PNPs heart transplant Intensive Laboratory Setting techniques ) Workers Psychologists or CNOs service Care Nurses Technicians 2. For categories of personnel that are unavailable, please describe how that function is addressed in the program. Pediatric Cardiology Continued Accreditation PIF 14
    • B. Support Facilities 1. Place a check mark in the appropriate spaces if these particular services are available at each of the participating institutions in the program. AVAILABLE AVAILABLE 24 HOURS/DAY Hosp 1Hosp 2Hosp 3Hosp 1Hosp 2Hosp 3 1. Diagnostic imaging facilities a) Diagnostic b) Flat Panel Detector c) Angiocardiogram 1. Single- and Bi-plane d) Digital computerized imaging e) Cardiac MRI and/or CT scanning f) Nuclear cardiology 2. Diagnostic & Interventional cardiac catheterization laboratory facilities, including physiological equipment as follows: a) Blood oxygen b) Blood gas and pH analysis c) Indicator-dilution techniques d) Stress test e) Cardiac output f) Electrophysiology ). Pressure 3. Echocardiography laboratory a) 2D b) Doppler c) Fetal d) Transesophageal 4. Non-invasive electrophysiology laboratory with facilities for performing and interpreting: a) Standard b) Ambulatory c) Exercise 5. Graphics laboratory for recording Echocardiography, exercise testing, Holter monitoring, etc. 6. Operating room(s) designed for pediatric patients and equipped for cardiopulmonary extracorporeal circulation. The area must be equipped with the following: a) Appropriate bedside monitoring devices b) Defibrillators c) Cardiac pacing devices 7. Blood Bank a) Type and cross-match blood 8. CT, UFCT 9. MRI Pediatric Cardiology Continued Accreditation PIF
    • AVAILABLE AVAILABLE 24 HOURS/DAY Hosp 1Hosp 2Hosp 3Hosp 1Hosp 2Hosp 3 1. Diagnostic imaging facilities 10. Continuous bedside monitoring 11. Exercise Testing 12. Transtelephonic telemetry 13. Clinical cardiac electrophysiologic laboratory for invasive intracardiac electrophysiological studies and catheter ablation. 2. If NO is indicated for any of the facilities and/or services in all the institutions above, explain how the service is provided for patients. If the facility or service is concentrated in one institution, explain how patients in the other institutions access these services or facilities. C. Inpatient Service/Outpatient Services 1. Indicate the availability of the following by checking the appropriate box. For inpatient services, indicate the number of available beds. Facility/Service Site 1 Site 2 Site 3 Space in an ambulatory setting for optimal evaluation and care of patients An inpatient area with full pediatric and related services (including surgery and psychiatry) staffed by pediatric residents and faculty Pediatric intensive care unit (total number of beds) Neonatal intensive care unit (total number of beds) Cardiac Intensive Care Units (total number of beds) Other intensive care units where children < 18 years are cared for (total number of beds) 2. For each location listed below where postoperative care is provided, indicate the role of the fellow in that care for each of the following age groups: neonates, infants, children, and adolescents. Role of Cardiology Fellow in Patient Care Designate as: Primary Provider (PP) Facility Consultant (C) Inpatient Area (exclusive of intensive care) PICU NICU CICU Other ICU Pediatric Cardiology Continued Accreditation PIF
    • I. PATIENT CARE A. Patient Data Provide the following information for the most recent 12-month period. The same timeframe should be used throughout the form. Inclusive Dates: From (mm/dd/yy): To (mm/dd/yy): INPATIENT Site 1 Site 2 Site 3 1. Total number of admissions for whom the pediatric cardiology service assumed major clinical responsibility a) Average daily census of patients on the pediatric cardiology service b) Number of new patients admitted each year (“new” refers to those who are being seen by pediatric cardiologists for the first time) c) Average length of stay of patients on the pediatric cardiology service: 2. Number of consultations by pediatric cardiologists on other inpatients a) Are consultations provided to the NICU? (Yes or No) If yes, how many? b) Are consultations provided to the PICU? (Yes or No) If yes, how many? AMBULATORY VISITS Site 1 Site 2 Site 3 1. Is there a separate cardiology clinic? (Yes or No) 2. If not, where are the ambulatory pediatric cardiology patients seen (e.g. offices, clinics, location?) 3. Number of pediatric cardiology ambulatory visits per year available to fellows. 4. Of this number, how many are new patients? (“new” refers to those who are being seen by members of the pediatric cardiology service for the first time.): 5. Number of pediatric cardiology clinic sessions per week: 1st Year: 2nd Year: 3rd Year: 6. Estimate the number of pediatric cardiology clinics a fellow attends per year in the program. Pediatric Cardiology Continued Accreditation PIF
    • B. 1Ambulatory Pediatric Cardiology Experience For All Years Of Training For New Applications: Indicate projected numbers for total fellows. Role of Fellow in Care of Patients – Average Name of Number of New Number of Designate as Number Experience Duration of Number of Patients Per Return Patients Primary Provider Teaching Use Site/Other Experience Sessions Per Fellow Per Per Fellow Per (PP) or Consultant Attending Per Setting Identifier (in wks/yr) Week Per Fellow Session Session (C) Session Pediatric Cardiology Continued Accreditation PIF
    • C. List of Diagnoses List 150 consecutive admissions (A) and consultations (C) by the Pediatric Cardiology service. Identify the time period during which these admissions/consultations occurred. The date range should occur within the same 12-month period used in I.A. The dates must begin on the date the first patient on the list was admitted and end with the date the 150th patient was admitted, e.g., July 1, 2007 through October 20, 2007. Submit a separate list for each site that provides required rotations. Use additional pages as necessary. Site Name: Inclusive Dates: From (mm/dd/yy): To (mm/dd/yy): Patient ID Number Age Cardiac Diagnosis Major Cardiac/Surgical Procedure(s) Pediatric Cardiology Continued Accreditation PIF
    • D. Pediatric Cardiology Surgical Statistics List 150 CONSECUTIVE cardiac operations on infants and children. Identify the time period during which these admissions/consultations occurred. The date range should occur within the same 12-month period used in I.A. The dates must begin on the date the first patient on the list underwent corrective heart surgery and end with the date the 150th patient underwent corrective heart surgery, e.g., July 1, 2007 through October 20, 2007. Submit a separate list for each site that provides required rotations. Use additional pages as necessary. Site Name: Inclusive Dates: From (mm/dd/yy): To (mm/dd/yy): Patient ID Number Age Primary Cardiac Diagnosis Major Surgical Procedure(s) Pediatric Cardiology Continued Accreditation PIF
    • E. Pediatric Cardiac Catheterization Statistics Please supply patient statistics for the same 12-month period used in I.A. Site Name: Inclusive Dates: From (mm/dd/yy): To (mm/dd/yy): Number of pediatric cardiac catheterizations during this interval: Age 0 - 30 days 13 months - 16 years Age 1 - 12 months over 16 years Procedures Total/Year a) Therapeutic 1. Septostomies 2. Valvuloplasties 3. Placement of devices b) Electrophysiologic 1. Diagnostic (EPS) 2. Therapeutic (Ablation) c) Pacemaker placement 1. Transcutaneous 2. Permanent Pediatric Cardiology Continued Accreditation PIF
    • F. Pediatric Procedures Summarize the procedures available for fellow experience. Do not include procedures on a "private" or "non-teaching" service which does not involve fellows. Indicate the total number performed, and the number of deaths for each procedure (where applicable), e.g., 12/2. This should include all procedures in the same 12-month period used on previous pages. Extract the information from the list of diagnoses in section 15 of this form. HAVE DOCUMENTATION AVAILABLE FOR THE SITE VISITOR. AGE ≥1 month and <1 <1 month year 1-21 Years TOTAL TOTAL TOTAL PERFORMED / PERFORMED / PERFORMED / NUMBER OF NUMBER OF NUMBER OF CLOSED PROCEDURES DEATHS DEATHS DEATHS 1. Shunts 2. PDA repair 3. Coarctation of aorta repair 4. Pulmonary artery banding OPEN PROCEDURES 1. VSD closure 2. Semilunar valvotomy 3. Tetralogy of Fallot repair 4. Transposition repair a. Simple b + VSD or – VSD + PS 5. Secundum ASD closure 6. Primum ASD closure 7. Complete AV canal – repair 8. Pulm. Atresia + VSD, truncus 9. Single ventricle, tricuspid atresia 10.Valve replacement (aortic, mitral) 11. Pacemaker implants 12.Cardioverter defibrillator AGE 0-30 Days 1-12 Months 1-21 Years NONINVASIVE DIAGNOSTIC TOTAL TOTAL TOTAL PROCEDURES PERFORMED PERFORMED PERFORMED 1. ECG 2. Fetal echocardiogram 3. Transesophageal echocardiogram 4. 2-dimensional echocardiogram 5. Nuclear medicine procedures 6. Stress tests with ECG monitoring 7. Ambulatory ECG Monitoring (Holter, Event) Pediatric Cardiology Continued Accreditation PIF
    • G. Fellow Procedures Give the number of procedures performed by each fellow who has completed this program in the most recent 3 years. HAVE DOCUMENTATION AVAILABLE FOR THE SITE VISITOR. Invasive/Non-Invasive Techniques Pediatric Intracardiac Total Electrophysiologic Echocardio- Trans- Fetal Ultra- Catheterizations Studies graphy esophageal Doppler sonography Fellow 1 Fellow 2 Fellow 3 Fellow 4 Fellow 5 Fellow 6 Pediatric Cardiology Continued Accreditation PIF 23
    • II. MEDICAL KNOWLEDGE A. Inpatient Experiences 1. Describe the responsibilities that fellows have for inpatients and how and by whom they are supervised. Limit response to 100 words 2. State how many hours per week fellows participate in rounds with faculty. Describe the fellow’s role in rounds. Limit response to 100 words B. Outpatient Experiences (If applicable) 1. Describe the responsibilities that fellows have for outpatients and how and by whom fellows are supervised. Limit response to 100 words 2. Describe the continuity of care experience fellows receive during their period of assignment to the outpatient clinic. To what extent do they have the opportunity to provide outpatient care for patients whom they treated on the inpatient service? Limit response to 100 words Pediatric Cardiology Continued Accreditation PIF 24
    • III. PRACTICE-BASED LEARNING AND IMPROVEMENT Examples of Learning Activities: didactic lecture, assigned reading, seminar, self-directed learning module, conference, small group discussion, workshop, online module, journal club, project, case discussion, one-on-one mentoring, or other examples of learning activities. 1. Describe one learning activity in which fellows engage to identify strengths, deficiencies, and limits in their knowledge and expertise (self-reflection and self-assessment); set learning and improvement goals; identify and perform appropriate learning activities to achieve self-identified goals (life-long learning). Limit your response to 400 words. 2. Describe one example of a learning activity in which fellows engage to develop the skills needed to use information technology to locate, appraise, and assimilate evidence from scientific studies and apply it to their patients’ health problems. The description should include: a) locating information b) using information technology c) appraising information d) assimilating evidence information (from scientific studies) e) applying information to patient care Limit your response to 400 words. 3. Give one example and the outcome of a planned quality improvement activity or project in which at least one fellow participated in the past year that required the fellow to demonstrate an ability to analyze, improve and change practice or patient care. Describe planning, implementation, evaluation and provisions of faculty support and supervision that guided this process. Limit your response to 400 words. 4. Describe how fellows: a) develop teaching skills necessary to educate patients, families, students, and other residents; b) teach patients, families, and others; and c) receive and incorporate formative evaluation feedback into daily practice. (If a specific tool is used to evaluate these skills have it available for review by the site visitor.) Limit your response to 400 words. 5. Describe the process for mentoring the fellows. Address the following items for each type of mentor if more than one is assigned to each fellow (i.e., if there is a separate research mentor). Describe (1) how mentors are selected, (2) how often the mentor meets with the mentee and (3) the guidelines that are provided for topics to be addressed during meetings between mentors and mentees. Limit response to 150 words (1) Pediatric Cardiology Continued Accreditation PIF 25
    • (2) (3) 6. Outline the faculty development activities that are provided for acquainting the faculty with mentoring skills. Limit response to 50 words 7. Learning Plans Is each fellow required to have an individualized learning plan? (If yes, please have learning plans ( ) YES ( ) NO available for site visitor verification.) ( ) No guidance, resident driven Who provides guidance to the fellow in ( ) Fellow’s mentor completing this plan (check all that apply)? ( ) Program Director ( ) Other (describe) ( ) Annually How often are these plans developed or updated? ( ) Semi- Annually ( ) Other (describe) 8. List the clinical quality improvement activities in which fellows actively participate and identify who guides them in this process. Limit response to 150 words 9. Using the bulleted list below (add bullets as needed) identify specific ways in which the program fosters reflection, self-assessment, and practice improvement for fellows. Limit response to 150 words • • Pediatric Cardiology Continued Accreditation PIF 26
    • IV. INTERPERSONAL AND COMMUNICATION SKILLS 1. Describe one learning activity in which fellows develop competence in communicating effectively with patients and families across a broad range of socioeconomic and cultural backgrounds, and with physicians, other health professionals, and health related agencies. Limit your response to 400 words. 2. Describe one learning activity in which fellows develop their skills and habits to work effectively as a member or leader of a health care team or other professional group. In the example, identify the members of the team, responsibilities of the team members, and how team members communicate to accomplish responsibilities. Limit your response to 400 words. 3. Explain (a) how the completion of comprehensive, timely and legible medical records is monitored and evaluated, and (b) the mechanism for providing fellows feedback on their ability to competently maintain medical records. Limit your response to 400 words. 4. How do fellows learn to achieve competence in conducting a family meeting to deliver critical/complex information about patient diagnosis, prognosis and /or treatment. Answer by using a specific example to illustrate. Limit response to 150 words 5. Describe (1) how the fellow’s written communication (including but not limited to progress notes, consults, and letters to referring physicians) is reviewed and (2) how feedback is given regarding its quality. Limit response to 150 words (1) (2) 6. Using the bulleted list below (add bullets as needed) identify the specific methods the program uses to ensure that fellows achieve competence in effective communication (verbal & written) in a consultative role with other physicians, health care workers and outside agencies. Limit response to 150 words • • Pediatric Cardiology Continued Accreditation PIF 27
    • V. PROFESSIONALISM 1. Describe at least one learning activity, other than lecture, by which fellows develop a commitment to carrying out professional responsibilities and an adherence to ethical principles. Limit your response to 400 words. 2. How does the program promote professional behavior by the fellows and faculty? Limit your response to 400 words. 3. How are lapses in these behaviors addressed? Limit your response to 400 words. 4. Explain how the following contribute to the evaluation of professionalism: (1) patients/families, and (2) members of the health care team. Attach as Appendix B the assessment tool that patients/families and members of the health care team use to evaluate professionalism (if different tools are used attach a copy of each). Limit response to 150 words (1) (2) 5. Using the bulleted list below (add bullets as needed) identify specific methods the program uses to teach and evaluate the elements of professional competence. Limit response to 100 words • • Pediatric Cardiology Continued Accreditation PIF 28
    • VI. SYSTEMS-BASED PRACTICE 1. Describe the learning activity(ies) through which fellows achieve competence in the elements of systems-based practice: work effectively in various health care delivery settings and systems, coordinate patient care within the health care system; incorporate considerations of cost- containment and risk-benefit analysis in patient care; advocate for quality patient care and optimal patient care systems; and work in interprofessional teams to enhance patient safety and care quality. Limit your response to 400 words. 2. Describe an activity that fulfills the requirement for experiential learning in identifying system errors. Limit your response to 400 words. a. Identify who guides/supervises fellows in this activity. Limit response to 75 words Teaching and Evaluation 1. Address how the elements of this competency are taught and how they are evaluated. (System errors are addressed in section 6b) and need not be included here. Limit response to 200 words 2. How does your program meet the requirement for exposure to administrative experience in the context of your subspecialty? Limit response to 200 words 3. Give an example of how fellows are expected to navigate the “system”, that is identify/access resources, make referrals, and coordinate services for patients within your subspecialty practice. Pediatric Cardiology Continued Accreditation PIF 29
    • APPENDIX A - GOALS AND OBJECTIVES Append a sample of the goals and objectives for one rotation. Pediatric Cardiology Continued Accreditation PIF 30