Background and Objectives: We sought to describe the process of integrating resident self-assessments into milestone assessments at the University of Texas Medical Branch Family Medicine Residency Program in Galveston, Texas. We compared resident self-assessments across milestones to Clinical Competency Committee (CCC) assessments across terms (fall versus spring) and by postgraduate year (PGY). Methods: In fall 2020, the milestone assessment process was updated to include a resident milestone self-assessment, which was used as the starting point for CCC assessment. We calculated mean and standard deviation of average milestone scores for both self-assessment and CCC for each PGY. We used repeated measure analysis of variance to examine within- and between-subject effects. Results: Self-assessment and CCC assessments were completed for 30 postgraduate trainees for spring 2020 and fall 2021 terms, for a total of 60 self- and 60 CCC assessments. CCC score was similar to self-assessment. There were larger variations in the resident self-assessment scores than CCC scores. Self-assessment scores increased by PGY, but were not different between fall and spring terms. We found a significant three-way interaction of assessors, terms, and PGYs. Conclusions: Resident milestone self-assessment enables residents to participate in the assessment process, and when differences exist between self- and CCC assessments, specific feedback can be given based on individual milestone skills. Our study showed progression between PGY regardless of the assessor, but only CCC assessment showed significant differences between terms.

Introduction: Family physicians use a variety of medications and techniques to perform intra-articular knee injections in the treatment of knee osteoarthritis. Currently, there is no consensus in the literature among the various specialties that perform joint injections for osteoarthritis of the knee regarding frequency of injections and injectate. The purpose of this study is to examine (1) the types of intra-articular knee injections used by family physicians for arthritis, (2) the most commonly used injectate, (3) the procedural approach, and (4) the maximum number of times the majority of family physicians would inject a single knee. Our study provides a descriptive epidemiology of current knee injection practices in the United States among family physicians. Methods: Surveys were emailed to family physicians. We evaluated and analyzed responses. Results: We received 360 responses, of which 317 family physicians indicated using intra-articular knee injections for pain. The majority (99%) used intra-articular injection steroid therapy in the treatment of knee osteoarthritis. About half (57.4%) of the family physicians would inject the same knee between one to five times. Conclusion: This study provides an overview of current practices in intra-articular injections among family physicians in the United States and provides important information regarding injection practices. Given the lack of consensus and that current practice contradicts evidence in the literature, consideration should be given among all specialties who perform joint injections to create evidence-based clinical practice guidelines to optimize patient care.