Clinical competence in ambulatory electrocardiography. A statement for physicians from the AHA/ACC/ACP Task Force on Clinical Privileges in Cardiology.

T he selective granting of clinical staff privileges to physicians is one of the primary mechanisms used by institutions to uphold the quality of care.The Joint Commission on Accreditation of Healthcare Organizations requires that the granting of initial or continuing medical staff privileges be based on assessments of applicants against professional criteria that are specified in the medical staff bylaws.Physicians themselves are thus charged with identifying the criteria that constitute professional competence and with eval- uating their peers on the basis of such criteria.Yet the process of evaluating a physician's knowledge and com- petence is often constrained by the evaluator's own knowledge base and ability to elicit the appropriate information, a problem that is compounded by the growing number of highly specialized procedures for which privileges are requested.This recommendation is one in a series developed to assist in the assessment of physician competence on a procedure-specific basis.The minimal education, train- ing, experience, and cognitive and technical skills nec- essary for competent ambulatory electrocardiographic interpretation are specified; whenever possible, these are based on published data linking these factors with competence in certain procedures and, in the absence of such data, on consensus of expert opinion.They are applicable to any practice setting and can accommodate a variety of pathways physicians might take to compe- tence in the performance of specific procedures (see also "Guide for the Use of American College of Physi- cians' Statements on Clinical Competence," Ann Intern Med.1987;107:588-589). Clinical Competence in Ambulatory Electrocardiography was ap- proved by the American Heart Association Steering Committee, the American College of Cardiology Board of Trustees, and the American College of Physicians Board of Regents.This report is being published simultaneously in Circulation and the Journal of the American College of Cardiology.