The Pediatrics Milestones: Initial Evidence for Their Use as Learning Road Maps for Residents

Schumacher, Daniel J.; Lewis, Kadriye O.; Burke, Ann E.; Smith, M. Lynne; Schumacher, Jayna B.; Pitman, Mary Anne; Ludwig, Stephan; Hicks, Patricia J.; Guralnick, Susan; Englander, Robert; Benson, Bradley J.; Carraccio, Carol

doi:10.1016/j.acap.2012.09.003

Cited by 39 publications

(22 citation statements)

References 16 publications

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“…7 It follows logically that residents would find milestone-based feedback useful in tracking their professional development, a finding also reported in the pediatric literature. 8 While we established that IM residents found a milestone-based framework for biannual evaluation at least as helpful as previous evaluations, our group anticipated a more positive response than 51% for strongly agree/agree. We had hypothesized that residents would find the specific, criterion-based narratives of the reporting milestones more helpful when compared to previous feedback.…”

Section: Discussionmentioning

confidence: 95%

Internal Medicine Residents' Perspectives on Receiving Feedback in Milestone Format

Angus¹,

Moriarty²,

Nardino³

et al. 2015

Journal of Graduate Medical Education

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Background In contrast to historical feedback, which was vague or provided residents' numerical scores without clear meaning, milestone-based feedback is focused on specific knowledge, skills, and behaviors that define developmental trajectory. It was anticipated that residents would welcome the more specific and actionable feedback provided by the milestone framework, but this has not been studied. Objective We assessed internal medicine (IM) residents' perceptions of receiving feedback in the milestone framework, particularly assessing perception of the utility of milestone-based feedback compared to non–milestone-based feedback. Methods We surveyed a total of 510 IM residents from 7 institutions. Survey questions assessed resident perception of milestone feedback in identifying strengths, weaknesses, and trajectory of professional development. Postgraduate years 2 and 3 (PGY-2 and PGY-3) residents were asked to compare milestones with prior methods of feedback. Results Of 510 residents, 356 (69.8%) responded. Slightly less than half of the residents found milestone-based feedback “extremely useful” or “very useful” in identifying strengths (44%), weaknesses (43%), specific areas for improvement (45%), and appropriate education progress (48%). Few residents found such feedback “not very useful” or “not at all useful” in these domains. A total of 51% of PGY-2 and PGY-3 residents agreed that receiving milestone-based feedback was more helpful than previous forms of feedback. Conclusions IM residents are aware of the concepts of milestones, and half of the residents surveyed found milestone feedback more helpful than previous forms of feedback. More work needs to be done to understand how milestone-based feedback could be delivered more effectively to enhance resident development.

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Section: Discussionmentioning

confidence: 95%

Internal Medicine Residents' Perspectives on Receiving Feedback in Milestone Format

Angus¹,

Moriarty²,

Nardino³

et al. 2015

Journal of Graduate Medical Education

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“…This should improve feedback given to trainees. 23 In a study of internal medicine residents, half found milestone-based feedback helped identify their strengths, weaknesses, specific areas for improvement, and educational progress, and felt that milestone-based feedback was more helpful than previous forms of feedback. 24 Specialty-specific milestones could help medical students plan their final year's medical school curriculum to prepare them for entering residency.…”

Section: Relationship To Other Variables: How Do Results From Milestomentioning

confidence: 99%

The Promise of Milestones: Are They Living Up to Our Expectations?

2017

Journal of Graduate Medical Education

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“…Although initial evidence provides insight into best practices, 18,21 including emphasizing current and next steps in development, further study will be needed. Optimal milestonesbased assessment will also require longitudinal relationships that allow adequate time and contact to identify current developmental level, define next steps in development, and effect behavior change from feedback.…”

Section: Domain 4: Summative Assessment and Feedback Develop Processementioning

confidence: 99%

“…Fortunately, initial evidence suggests that both residents and faculty understand the milestones-based assessment framework when oriented to it. 18,20,21 Staff and Other Assessor Development…”

Section: Faculty and Resident Developmentmentioning

confidence: 99%

“…6 This provides a learning roadmap to inform curriculum as well as supervisors' efforts to help trainees take the next steps in their development. [16][17][18] Milestones-based assessment is a paradigm shift from current assessment methods that rely heavily on faculty judgments of resident performance based on their level of training. 19 With milestones, assessors will be required to match observed behaviors in trainees with descriptions of those behaviors along a developmental milestones trajectory independent of training level.…”

Section: Faculty and Resident Developmentmentioning

confidence: 99%

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Putting the Pediatrics Milestones Into Practice: A Consensus Roadmap and Resource Analysis

et al. 2014

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The Accreditation Council for Graduate Medical Education has partnered with member boards of the American Board of Medical Specialties to initiate the next steps in advancing competency-based assessment in residency programs. This initiative, known as the Milestone Project, is a paradigm shift from traditional assessment efforts and requires all pediatrics residency programs to report individual resident progression along a series of 4 to 5 developmental levels of performance, or milestones, for individual competencies every 6 months beginning in June 2014. The effort required to successfully make this shift is tremendous given the number of training programs, training institutions, and trainees. However, it holds great promise for achieving training outcomes that align with patient needs; developing a valid, reliable, and meaningful way to track residents’ development; and providing trainees with a roadmap for learning. Recognizing the resources needed to implement this new system, the authors, all residency program leaders, provide their consensus view of the components necessary for implementing and sustaining this effort, including resource estimates for completing this work. The authors have identified 4 domains: (1) Program Review and Development of Stakeholders and Participants, (2) Assessment Methods and Validation, (3) Data and Assessment System Development, and (4) Summative Assessment and Feedback. This work can serve as a starting point and framework for collaboration with program, department, and institutional leaders to identify and garner necessary resources and plan for local and national efforts that will ensure successful transition to milestones-based assessment.

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The Pediatrics Milestones: Initial Evidence for Their Use as Learning Road Maps for Residents

Cited by 39 publications

References 16 publications

Internal Medicine Residents' Perspectives on Receiving Feedback in Milestone Format

Internal Medicine Residents' Perspectives on Receiving Feedback in Milestone Format

The Promise of Milestones: Are They Living Up to Our Expectations?

Putting the Pediatrics Milestones Into Practice: A Consensus Roadmap and Resource Analysis

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