TY - JOUR
T1 - Miles to Go before We Sleep Reforming the Pulmonary and Critical Care Milestones to Improve Trainee Assessment
AU - Heath, Janae K.
AU - Dempsey, Timothy M.
AU - Santhosh, Lekshmi
AU - Edgar, Laura
AU - Fessler, Henry E.
N1 - Publisher Copyright:
© 2020 by the American Thoracic Society.
PY - 2020/3
Y1 - 2020/3
N2 - The Accreditation Council for Graduate Medical Education (ACGME) Milestones are a systematic assessment framework for medical trainees within the six core competencies of practice. Their use by internal medicine subspecialties, including semiannual reports to the ACGME, was mandated beginning in 2014. The Milestones, which were based on specific, observable behaviors, improved upon the prior subjective, global comparisons of each fellow with an "average"fellow in his or her field and served the goals of competencybased medical education. However, the original set of Milestones has proven challenging to apply and interpret. Part of the challenge stems from the use of identical Milestones across all medicine subspecialties, which led to unclear relevance of the patient care and medical knowledge domains to the practice of pulmonary and critical care. This also precluded their use for individualized feedback or development of a learning plan for fellows. In addition, verbose behavioral descriptors, which were designed to provide specificity, ultimately led to rater fatigue among assessors and clinical competency committees. Therefore, the ACGME convened committees for each of the medical subspecialties to revise the original Milestones in an effort to improve subspecialty relevance, minimize educational jargon, and simplify the current iteration. New patient care and medical knowledge Milestones were created to be subspecialty specific and improve utility. The remaining four Milestones were developed as a common set of shorter Milestones, harmonized across specialties. For pulmonary, critical care, and combined fellowship programs, the resulting Milestones 2.0 aims to simplify the use, implementation, and interpretation of this framework for program directors, trainees, and society.
AB - The Accreditation Council for Graduate Medical Education (ACGME) Milestones are a systematic assessment framework for medical trainees within the six core competencies of practice. Their use by internal medicine subspecialties, including semiannual reports to the ACGME, was mandated beginning in 2014. The Milestones, which were based on specific, observable behaviors, improved upon the prior subjective, global comparisons of each fellow with an "average"fellow in his or her field and served the goals of competencybased medical education. However, the original set of Milestones has proven challenging to apply and interpret. Part of the challenge stems from the use of identical Milestones across all medicine subspecialties, which led to unclear relevance of the patient care and medical knowledge domains to the practice of pulmonary and critical care. This also precluded their use for individualized feedback or development of a learning plan for fellows. In addition, verbose behavioral descriptors, which were designed to provide specificity, ultimately led to rater fatigue among assessors and clinical competency committees. Therefore, the ACGME convened committees for each of the medical subspecialties to revise the original Milestones in an effort to improve subspecialty relevance, minimize educational jargon, and simplify the current iteration. New patient care and medical knowledge Milestones were created to be subspecialty specific and improve utility. The remaining four Milestones were developed as a common set of shorter Milestones, harmonized across specialties. For pulmonary, critical care, and combined fellowship programs, the resulting Milestones 2.0 aims to simplify the use, implementation, and interpretation of this framework for program directors, trainees, and society.
KW - Graduate medical education
KW - academic performance
KW - clinical competence
KW - training programs
UR - http://www.scopus.com/inward/record.url?scp=85130590830&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85130590830&partnerID=8YFLogxK
U2 - 10.34197/ats-scholar.2019-0013PS
DO - 10.34197/ats-scholar.2019-0013PS
M3 - Article
AN - SCOPUS:85130590830
SN - 2690-7097
VL - 1
SP - 33
EP - 43
JO - ATS Scholar
JF - ATS Scholar
IS - 1
ER -