American College of Cardiology/American Heart Association Clinical Competence statement on stress testing: a report of the American College of Cardiology/American Heart Association/American College of Physicians--American Society of Internal Medicine Task Force on Clinical Competence.

The granting of clinical staff privileges 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 assessment of applicants against professional criteria specified in medical staff bylaws. Physicians and other healthcare providers are thus charged with identifying the criteria that constitute professional competence and with evaluating their peers accordingly. The process of evaluating clinical knowledge and competence is often constrained by the evaluator’s own knowledge 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. The American College of Cardiology (ACC)/American Heart Association (AHA)/American College of Physicians– American Society of Internal Medicine (ACP-ASIM) Task Force on Clinical Competence was formed in 1998 to develop recommendations to attain and maintain the cognitive and technical skills necessary for the competent performance of a specific cardiovascular service, procedure, or technology. These documents are evidence based, and where evidence is not available, expert opinion is called upon to formulate recommendations. Indications and contraindications for specific services or procedures are not included in the scope of these documents. Recommendations are intended to assist those who must judge the competence of cardiovascular healthcare providers entering practice for the first time and/or those who are in practice and undergo periodic review of their practice expertise. Because the assessment of competence is complex and multidimensional, isolated recommendations contained herein may not necessarily be sufficient or appropriate for judging overall competence. Board specialty certification is not a required part of these recommendations but is another measure of expertise.