Table of Contents

Hospice and Palliative Medicine Competencies (version 2.3, September 2009)

Measurable Behavior Outcomes (version 2.3, September 2009)

Toolkit of Assessment Methods

The following links are the assessment tools organized by ACGME Competency. Click on each to download the assessment tool as a Word form. The introduction provides background information about the toolkit and instructions for use.

• Introduction (pdf)
• Patient and Family Care (PFC)
  • PFC 3-Tool Bundle
    • Patient and Family Care - Attending Physician Assessment
    • Patient and Family Care - Fellow Self-Assessment
    • Patient and Family Care - Chart Review
  • Chart Abstraction Checklist - Psychosocial-Spiritual Assessment
  • Chart Abstraction Checklist - Pain Assessment
• Practice-Based Learning and Improvement
  • Faculty Evaluation of Fellow: Checklist - Practice-Based Learning and Improvement
  • Team Evaluation of Fellow: Checklist - Practice-Based Learning and Improvement
  • Small Group Teaching Checklist
• Interpersonal and Communication Skills
  • The SECURE Framework - Palliative Care
  • Communication Skills Evaluation
• Professionalism
  • Assessment of Professionalism in Palliative Care
  • Reflective Journaling Self-Care Exercise
• Systems-Based Practice
  • Team Evaluation of Fellow: Checklist - Systems-Based Practice
  • Faculty Evaluation of Fellow: Checklist - Systems-Based Practice
• Multi-Domain Tools and Master Assessment Table
  • 360° Evaluation
  • Academic Portfolio
  • Palliative Medicine Structured Portfolio
  • Master Assessment Table

Guide to Key Documents
Instructions for Using Forms
Resources for More Information

For questions send an email to This e-mail address is being protected from spambots. You need JavaScript enabled to view it This e-mail address is being protected from spambots. You need JavaScript enabled to view it  or call 847/375-4712.

Contributors to the Hospice and Palliative Medicine Competencies Project