Schoolwide Competencies and Objectives

RWJMS has adopted the Accreditation Committee for Graduate Medical Education competencies (ACGME) to serve as organizational curriculum framework for medical students. The detailed school-wide competencies and measurements described below.

I. Patient Care

Students must be prepared to provide patient care that is compassionate, appropriate and effective.


Objective(s) Description Outcome Measure(s)
A. Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families Students will establish therapeutic relationships with diverse patients through the lifespan; utilize the psychosocial and cultural context of the patient, which fosters effective communication; and recognize and discuss the importance of family dynamics in health care decision making. Faculty observations/feedback, clerkship evaluations, OSCE's, summative clinical skills assessment, USMLE Step 2 CS
B. Gather essential and accurate information about their patients Students will conduct effective interviews with patients and elicit complete and focused medical histories relevant to the chief concern; perform complete and focused physical examinations; identify components of the physical exam that are critical to the clinical presentation; identify abnormal findings; and relate differential diagnosis and examination findings. MCQ, faculty observations and feedback, observed full history and physical examination, clerkship evaluations, OSCE's, mini CEX, summative clinical skills assessment, USMLE 2 CS, USMLE Step 2CK
C. Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment Students will identify differential diagnoses for cardinal presentations; indicate appropriate evaluation plans; modify diagnostic strategies in response to test results; and develop appropriate management plans for patients using evidence-based medicine. MCQ, faculty observations and feedback, performance on course quizzes & examinations, performance in small group exercises, clerkship evaluations, OSCE, summative clinical skills assessment, USMLE 2CS, USMLE Step 2CK
D. Counsel and educate patients and their families Students will evaluate a patient’s level of understanding and its potential impact on education and counseling; use lay person terminology to explain disease processes and procedures; and develop approaches to counsel and educate patients and families, which are individualized to the patient/family situation. Faculty observations and feedback, clerkship evaluations, OSCE's, summative clinical skills assessment, interprofessional collaborative care plan exercise and exam
E. Use information technology to support patient care decisions and patient education Students will identify credible information sources for research and education and use best evidence to develop diagnostic and management plans and to provide patient education. Faculty observations and feedback, MCQ, narrative and oral feedback for EBM activities
F. Perform required clinical procedures Students will perform basic life support; apply universal precautions; and perform designated procedures with proper techniques and consideration of patient’s rights. Completion of BLS requirement, pass universal precautions course, pass procedures course, faculty testing, faculty observation and feedback, procedure logs
G. Work with patients in maintaining health Students will identify risk factors for illness or injury within the context of the individual, the family, work, and the social environment; identify standardized approaches for changing health behavior; and describe regimens for health maintenance. Faculty observations/evaluations, MCQ's, Clerkship evaluations, NBME subject exams, OSCEs
H. Work as members of multi-disciplinary health care teams to provide patient- focused care Students will identify and describe the components of patient centered care in practice environments; interact appropriately with other healthcare team members; and identify the many roles that health care members have in patient care. Student portfolio, interprofessional collaborative care plan exercise and examination; clerkship evaluations
II. Medical Knowledge

Students must demonstrate knowledge about established and evolving basic and clinical biomedical sciences, including epidemiological and social/behavioral sciences, and their application of this knowledge to patient care.


Objective(s) Description Outcome Measure(s)
A. Demonstrate knowledge and application of the basic and clinical sciences relevant and appropriate to the clinical practice of medicine Students will demonstrate knowledge of the molecular, biochemical, genetic and cellular mechanisms that are important in normal human development, aging, and in maintaining the body's homeostasis; the physical structure of the human body, of its tissues and organs, of how organs and tissues function, and how these functions are regulated and integrated, through the life cycle; the various acquired and congenital causes of disease or injury in individuals and in populations; how nutrition, health behaviors and preventive measures influence health and disease in individuals and in populations; the altered structure and function of the human body and its cells, tissues and organs, which are seen in various disease conditions or with aging, and of the fundamentals of diagnosis and treatment regimens that may be applied to address these conditions; the physical and functional determinants of human cognition, awareness, behavior and personality, of how alterations of these result in disease conditions, and of the fundamentals of diagnosis and treatment regimens that may be applied to address these conditions.; the power of the scientific method in establishing cause and effect in human health and disease, the efficacy of traditional and non-traditional therapies, and the ability to critically evaluate contemporary reports in basic and clinical sciences; and application of knowledge in the basic sciences fundamental to clinical practice, to the processes of diagnosis, treatment, and prevention in the clinic and in the community. Formative and summative quizzes and course exams (MCQ), faculty observations and feedback in small group exercises, project assessment, cumulative exam, NBME CBSE, USMLE Step 1, USMLE Step 2 CK, NBME subject examinations, student presentations, clerkship evaluations
B. Demonstrate an investigatory and analytic thinking approach to clinical situations Students will demonstrate the ability to seek and identify credible data that addresses issues in basic sciences fundamental to clinical practice and in clinical practice itself, and to interpret that data; and demonstrate knowledge about established and evolving clinical biomedical sciences and the application of this knowledge to patient care. MCQ exams: faculty observations and feedback, clerkship evaluations; NBME Subject exams
III. Practice-Based Learning and Improvement

Students must be able to engage in self- evaluation regarding their academic and clinical performance, develop plans for personal improvement, and recognize how the application of new learning can be used to improve patient care.


Objective(s) Description Outcome Measure(s)
A. Demonstrate strategies to analyze academic and clinical performance over the course of their professional careers, and develop improvement plans, in a methodical fashion Students will assess their needs in basic science and clinical courses and establish strategies for improvement; develop reflective practice habits using analysis of academic and clinical experiences to improve clinical performance; demonstrate skills in self-directed learning by developing clinical questions about patients and using credible information sources to find relevant medical information to answer them; and determine the limits of their expertise and consult with others. Faculty observations and feedback; portfolios; formative assessment; integration exercise; independent project; clerkship evaluations
B. Locate, appraise, and assimilate evidence from scientific & clinical studies related to patients' health problems Students will systematically appraise and assimilate scientific evidence through reading of articles related to patient health. Faculty observations and feedback; portfolio, independent project, EBM presentations/exercises, post simulation EBM exercise, clerkship evaluations
C. Obtain and use information about patients they care for and the larger population from which these patients are drawn Students will define basic epidemiological terms and concepts; identify the appropriate use of frequently used study designs; understand the application of basic biostatistical calculations; apply concepts of epidemiology and biostatistics for diagnostic screening, risk management, and therapeutic decision making; and obtain and use information about the patients they care for and the larger population of patients with similar clinical conditions to refine their diagnostic, management and prognostic elements. MCQ exams; faculty observations and feedback,clerkship evaluations, EBM presentations. independent project
D. Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness Students will use credible information sources to locate information related to diagnostic and therapeutic clinical decision making; identify the appropriate use of frequently used study designs; understand the application of basic biostatistical calculations; critically appraise clinical trials; and describe the principles of prudent ordering of diagnostic and screening tests and use these principles in devising management plans. Faculty observations and feedback, MCQ exams, clerkship evaluations: EBM presentations
E. Use information technology to manage information, access online medical information, and support their education Students will demonstrate facility with the use of information technology to meet learning demands, prepare for case discussions and engage in clinical reasoning. Faculty observations and feedback; clerkship evaluations, integration project
F. Facilitate the learning of other students and health care professionals Students will work collaboratively in small groups; participate in teaching activities; work collaboratively with students and other health care professionals; and appropriately share and elucidate clinical information. Faculty observations and feedback; peer assessment; evaluation of teaching effectiveness, case presentations, clerkship evaluations
IV. Interpersonal and Communication Skills

Students must be able to demonstrate interpersonal and communication skills, both verbal and written, that result in effective information exchange with patients, patients' families, peers, and other health professions colleagues.


Objective(s) Description Outcome Measure(s)
A. Create and sustain a therapeutic and ethically sound relationship with patients in order to effectively communicate their health care needs, including situations involving sensitive, technically complex, or distressing information Students will communicate respectfully with diverse patients; demonstrate appropriate behavior when interacting with patients and other health professionals providing care; demonstrate ethically appropriate interactions with patients; establish a therapeutic relationship with all patients and their families; and adapt their communication style to the individual needs of the patient and the urgencies of the situation. Faculty observations and feedback, clerkship evaluations, OSCEs, summative clinical skills Assessment, USMLE 2CS
B. Utilize appropriate and effective communication Students will use techniques which foster effective communication including active listening, clarification of patient responses, encouragement of sharing concerns and questions; deliver information to patients with appropriate communication strategies including use of the explanatory model, assessing the patient's understanding with direct questioning, and with written instructions; conduct a culturally-competent encounter, including use of an interpreter when necessary; and create and maintain appropriate records of clinical encounters using standard terminology and formats, including written patient history and physicals, in-patient and out-patient encounter notes and case log information. Faculty observations and feedback; history and physical examination write-ups, portfolio write-ups, clerkship evaluations; OSCEs; summative clinical Skills assessment, USMLE Step 2 CS
C. Work effectively with others as members of a health care team, including peers, residents, faculty and other health care professionals Students will participate effectively in small groups; participate effectively in clerkship clinical activities with attendings, residents, and other health professionals; provide concise, accurate, verbal summaries of patient situations to a faculty member, resident or peer, prioritizing the most significant factors for clinical decision-making; identify their responsibilities as members of a health care team; and establish effective communication among members of the health care team, including appropriate written and other communications. Faculty observations and feedback; peer evaluations, clerkship evaluations; OSCEs; patient note assessment
V. Professionalism

Students must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.


Objective(s) Description Outcome Measure(s)
A. Demonstrate respect, compassion, and integrity in interactions with peers, patients, and other health professionals Students will demonstrate preparedness for class, meetings and patient care activities; convey information honestly and tactfully; engage in truthful interactions with patients, peers, and in professional work; act and dress in a professional; maintain appropriate boundaries in work/learning/patient care situations; demonstrate respect for the wishes of patients; attend to patient needs for comfort and privacy; demonstrate respect in relationships toward other health care team members and patients; relate collegially to fellow students, faculty and staff in learning environments; will listen to others respectfully and attentively; resolve conflicts in a collegial manner; and demonstrate attitudes and behaviors which convey respect for other students, faculty and staff in all situations and will be receptive to diverse opinions and values. Faculty observations and feedback; clerkship evaluations; OSCEs
C. Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, and informed consent Students will not discriminate regardless of race, gender, religion, sexual orientation, age, disability, intelligence and socio-economic status; react appropriately to other's lapses in conduct and performance; maintain the confidentiality of examination material; identify the principles of patient confidentiality, informed consent, and information sharing; and recognize the importance of ethical decision making. Peer assessment; faculty observation & feedback; lack of professionalism citations; completion of HIPAA training, completion of CITI training, portfolio entries
D. Demonstrate sensitivity and responsiveness to patient individuality including the role of culture, ethnicity, gender, age, disabilities, and other aspects of health practices and decisions Students will demonstrate sensitivity and respect in patient interactions regardless of race, gender, religion, sexual orientation, age, disability, intelligence, and socio-economic status; and recognize the need for patient involvement in decision making and the incorporation of patients' values and beliefs into management plans. Faculty observations and feedback; portfolio entries, clerkship evaluations; OSCEs, mini-CEX, summative clinical skills assessment
E. Recognize and address personal limitations, attributes or behaviors that might influence their effectiveness as a physician Students will demonstrate self-motivation and accountability for their own learning; seek help when needed; accept constructive criticism and modify behavior based on feedback; maintain responsibility for the physical and mental health of themselves and their peers; admit to errors of omission and commission and assume responsibility; inform a supervisor when mistakes occur; and maintain composure during difficult interactions. Academic progress; faculty observations and feedback; professionalism citations, clerkship evaluations, OSCEs
VI. Systems-Based Practice

Students will be able to function effectively in teams and within a larger organizational structure. They must demonstrate an awareness of the larger context and system of health care and of the resources available within the system to provide optimal care to individual patients and groups. Finally, students must demonstrate awareness of current barriers to health care and of the various strategies designed to assist patients in gaining access to care.


Objective(s) Description Outcome Measure(s)
A. Demonstrate effective involvement in a health care team and be able to recognize how their involvement in patient care may affect other members of the health care profession Students will participate effectively in small groups, discuss the interdisciplinary approach to improving health care, and identify the basic components of the health care system and their interdependencies;and participate effectively in clerkship clinical activities with attendings, residents, and other health professionals Faculty observations and feedback; clerkship evaluations, portfolio, interprofessional collaborative care examination, simulation exercises
B. Know how types of medical practice and delivery systems differ from one another, including their methods of controlling health care costs and allocating resources Students will compare and contrast different types of medical practice and delivery systems and identify methods for allocation of resources and controlling health care costs; recognize that participation in patient care in various settings, (e.g., emergent/urgent care facilities, underserved clinics and communities, long-term care facilities and tertiary academic/community hospital settings) has unique priorities, opportunities and constraints that may affect health care; describe how different methods of cost control affect physicians' relationships with their colleagues, their patients, and society; and describe the strengths and shortcomings of the U.S. system for financing and delivering medical care, particularly to those from underserved/minority groups. Completion of health systems modules, faculty observations and feedback; portfolio, clerkship evaluations
Describe the principles of cost-effective health care and resource allocation that does not compromise quality of care Students will learn principles of cost- effective health care and the allocation of resources and describe realities that enhance/ hinder implementation and recognize appropriate cost-effective decision making and resource allocation Completion of health systems modules, faculty observations and feedback; portfolio, clerkship evaluations
D. Advocate for quality patient care and assist patients in dealing with system complexities Students will assess the health care needs of their patients and a community site; use effective communication strategies to educate and counsel patients in dealing with health care complexities and overcoming barriers to health care access; recognize appropriate consultation resources that can optimize patient care and management of health behaviors, including different physician specialties, other health care professionals, and community health agencies; and describe strategies to enhance collaboration of these resources. Faculty observations and feedback; portfolio; clerkship evaluations
E. Be aware of how to partner with health care managers and health care providers to assess, coordinate, and improve health care and know how these activities can affect system performance Students will recognize the importance of practice guidelines and quality improvement for patient safety; outline strategies for effective quality assurance, including partnership with other health care managers/providers and the utilization of information; and recognize the source of common medical errors and discuss strategies to address them. Clerkship evaluations; faculty observations and feedback; portfolio, QI projects