This post was authored by William J. Oetgen, MD, MBA, FACC, ACC executive vice president of Science, Education and Quality.

For the past decade assessments of graduate medical education have focused on six competencies that characterize the attributes of the ideal physician: their medical knowledge, patient care and clinical skills, professionalism, interpersonal and communication skills, practice-based learning and improvement, and systems-based practice.

Because developing an effective curricula for, and measurement of, practice-based learning and improvement and systems-based practice has proven to pose particular challenges for teaching programs, the PINNACLE Registry was used to assess compliance with the ACC, the American Heart Association, and the American Medical Association-Physician Consortium for Performance Improvement performance measures for coronary artery disease, hypertension, heart failure, and non valvular atrial fibrillation in cardiology the fellowship program at St. John Hospital and Medical Center in Detroit, Michigan.

A report of the findings was recently published in the Journal of Graduate Medical Education, led by Melissa Frederick, MD, clinical cardiologist at Kindred Hospital, and found that through 2012, trainees prospectively entered data for ambulatory cardiac patients into the PINNACLE database complying with 28 performance measures that were calculated and reported on a quarterly basis. Fellows would also meet with their program director individually and as a group to identify specific performance gaps, developing and implement plans for respective areas of improvement. On an annual basis the fellows were surveyed to convey their own thoughts on training process.

Concluding their time, eight of the 12 fellows described positive effects on their practice-based learning and improvement, with eight of 12 also noting a positive effect on their systems-based practice. Nine of the 12 fellows also reported improvement in their knowledge of disease-specific therapy.

Despite limitations of being a single-center study of an ambulatory practice with just 12 cardiology fellows, the results of the years-long assessment demonstrated that PINNACLE offered a foundation of data on which quality improvement projects can be planned and studied.

With a large part of the ACC’s new strategic plan focusing on data information and knowledge, the ACC will continue to use data to generate science and improve clinical practice consistent with the Triple Aim of better outcomes, better care and lower costs.

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