Components of the Practice-Based Learning and Improvement (PBLI) Competency

This competency requires the trainee to learn the basics of life-long learning through a review of their own practice experiences. The ACGME components can be found in the ACGME’s Common Program Requirements in Section IV.A.5.C.

Suggested GOALS:
1. Recognize the need for self reflection of one’s practice;
2. Learn how to critique their practice; and
3. Learn how to access the new information needed to improve their outcomes.

1. Submit cases for M&M conference, including ‘near misses’;
2. Present at M&M conference with literature review;
3. Participate in a Quality & Safety project;
4. Attend and participate in Journal Club;
5. Ask for and accept feedback;
6. Change behavior based on feedback and reflection; and
7. Teach medical students, patients, families, and health care professionals.

The Institute for Healthcare Improvement (IHI), an independent not-for-profit organization based in Cambridge, Massachusetts, is a leading innovator in health and health care improvement worldwide. Their web site has valuable suggestions related to patient safety and quality, which are at the core of Practice-based Learning and Improvement.

Suggested EVALUATION questions:
1. Does the trainee accept feedback?
2. Does the trainee recognize/acknowledge errors?
3. Does the trainee submit cases to M&M?
4. Does the trainee present at M&M?
5. Does the trainee attend Journal Club?
6. Does the trainee participate in Journal Club?
7. Does the trainee know the patient population characteristics?
8. Is the trainee culturally sensitive?
9. Does the trainee use the medical literature to direct patient care?
10. Is the trainee able to find pertinent literature related to the patient’s care?
11. Is the trainee able to interpret the medical literature?
12. Does the trainee use the electronic medical record?
13. Does the trainee teach medical students?
14. Does the trainee teach patients and their families?
15. Does the trainee teach health care professionals?
16. Is the trainee involved in a Quality & Safety Improvement project?
Optimally, the answers would be descriptive text but they could be on a numerical scale.


1. Canal DF, et al. Practice-Based Learning and Improvement: A Curriculum in Continuous Quality Improvement for Surgery Residents. Arch Surg 2007: 142:479-483.
2. Falzer PR, Garman DM. Evidence-based Decision-making as a Practice-based learning Skill: a pilot study. Acad Psychiatry 2012; 36(2): 104-9.
3. Lawrence RH, Tomolo AM. Development and Preliminary Evaluation of a Practice-based Learning and Improvement Tool for Assessing Resident Competence and Guiding Curriculum Development. J Grad Med Ed 2011; 3(1): 41-48.
4. Nothnagle M, et al. Struggling to Be Self-Directed: Residents’ Paradoxical Beliefs About Learning. Acad Med 2011; 86 (12):1539-1544.
5. Ogrinc G, et al. Teaching and Assessing Resident Competence in Practice-based Learning and Improvement. J Gen Intern Med 2004; 19:496-500.
6. Ogunyemi D, et al. Evaluating Professionalism, Practice-Based Learning and Improvement, and Systems-Based Practice: Utilization of a Compliance Form and Correlation with Conflict Styles. J Grad Med Ed 2010; 2(3):423-429.
7. Post RE, et al. Resident-as-teachers Curricula: A Critical Review. Acad Med 2009; 84(3): 374-380.
8. Salzman DH, et al. Assessing Practice-based Learning and Improvement. Acad Emerg Med. 2012; 19 (12):1403-1410.
9. Smith SJ, et al. Internal Medicine Residents’ acceptance of Self-directed Learning Plans at the Point of Care. J Grad Med Educ 2011 3(3): 425-428.
10. Tomolo AM, et al. Pilot Study Evaluating a Practice-based Learning and Improvement Curriculum Focusing on the Development of System-level Quality Improvement Skills. J Grad Med Ed 2011; 3(1): 49-58.
11. Ziegelstein RC, et al. “The Mirror” and “The Village”: A New Method for Teaching Practice-Based Learning and Improvement and Systems-Based Practice. Acad Med 2004; 79:83-88.


This page was last updated on 8/23/13




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