Pediatric Competencies DRAFT
- Practice patient-centered and relationship-based care.
- Recognize the value of relationship-centered care as a tool to facilitate healing.
- Demonstrate respect and understanding for the family's and patient's interpretations of health, disease, and illness that are based upon their cultural beliefs and practices.
- Demonstrate the ability to reflect on elements of patient and parent encounters, including personal bias and belief, to facilitate understanding of relationship-centered care.
- Demonstrate patient-centered history taking, using a bio-psychosocial approach that includes an accurate nutitional history, spiritual history, inquiry of conventional and complementary treatments, and emotional climate of the household. Include information regarding prior coping strategies/styles, temperament, evolution of understanding the patient's medical condition and how (if) that has changed with time.
- Collaborate with patients in developing and carrying out a health screening and management plan for disease prevention, and management of chronic disorders if application, and treatment using conventional and complementary therapies when indicated. May include discussion of possible 'obstacles.'
- Understand the evidence base for the relationships between health and disease and the following factors: emotion, stress, nutrition, physical activity, social support, spirituality, sleep, and environment.
- Understand the importance of prior medical encounters, including past experience with 'painful/stressful' procedures such as blood draws and IV insertions. Assess whether any complementary treatments were used.
- Use EBM resources, including those related to CAM, at the point of care.
- Identify reputable print and/or online resources on conventional and complementary medicine to support professional learning.
- Evaluate the strengths and limitations of evidence-based medicine (EBM) as it applies to conventional and complementary approaches and its translation into patient care. Understand that these limitations also exist in 'conventional' treatments.
- Demonstrate understanding of common complementary medicine therapies, including their history, theory, proposed mechanisms, safety/efficacy profile, contraindications, prevalence, patterns of use, cost, and an appreciation that these may be evolving.
- Identify personal learning needs related to conventional and complementary medicine, emphasizing the realization that these are broad, evolving fields and therefore the need to have resources available is part of all medical training. It is 'OK' to say "I don't know," but this should be followed by "but I will search for the answer."
- Facilitate health behavior changes in patients, using techniques such as motivational interviewing or appreciative inquiry.
- Demonstrate respect for peers, staff, consultants, and CAM practitioners who share in the care of patients. Knowledge and acceptance needs to begin within medical culture. Consider the importance of school coaches/instructors if appropriate for the child's well-being: most commonly needed for mental health/behavioral issues.
- Understand importance of self-care practices to improve personal health, maintain work-life equilibrium, and serve as a role model for patients, staff, and colleagues. Identify whether or not there is personal experience with integrative medicine, and if there was any experience within Medical and Undergraduate training.
- Understand difference reimbursement systems and their impact on patient access to both conventional and complementary interventions.
- Understand national and state standards related to training, licensing, credentialing, and reimbursement of community CAM practitioners.
- Collaborate with community CAM practitioners and other healthcare specialists in the care of patients, while understanding legal implication and appropriate documentation issues.
- Identify strategies for facilitating access to integrative medicine services for their patients, including low-income populations.
- Understand the principles of designing a healthcare setting that reflects a healing environment.
- Professional education: maintain competency in the practice of their primary specialty such that it conforms to the standards and expectations of peer organizations, specialty groups and licensing requirements.
- Continuing Medical Education: participate in and track records of CME in the multitude and ever changing fields of interest to integrative health professionals.
- Professional conduct: eschew illegal activity and unethical practice related to patients, employees, peers and associates.
- Professional responsibilities: maintain a cooperative attitude in patient relationships based on a mutual decision as to what is best for the patient.
- Professional confidentiality: Within any legal requirements, safeguard confidentiality of patient information and records, affirming the rights of patients to obtain their records for their own purposes.
- Community standards: abide by prevailing community standards and law in regard to business practices. Advertising will be honest and factual. Unethical sharing of fees and conflicts of interest will be avoided.
- Principles of practice: commit to enhancing knowledge, competence and expertise in integrative medicine to the greatest benefit of patients.
 Adopted from AM Board of Integrative / Holistic Medicine
Locke, AB, Gordon, A, Guerrera, MP, Gardiner, P, and Lebensohn, P. Recommended Integrative Medicine Competencies for Family Medicine Residents. Explore 2013; 9:308-313 & 2013 Elsevier Inc.
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