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  1. Implementing Milestones:Historical context, competency based medical education, and outcomes CORD Academic Assembly April 2, 2012 Felix Ankel Michael Beeson Patrick Brunett

  2. http://www.youtube.com/watch?v=Qy1dpLmJTrY&feature=related

  3. Druck e-mail

  4. www.wordle.net Worldle map

  5. Dreyfus model of skill acquisition

  6. Six Aptitudes

  7. Druck e-mail

  8. Milestones • Observable, measurable behaviors • Acknowledges developmental stages • Linked to level of training • Expected time frame for achievement

  9. Milestones • Narrative anchors • Based on knowledge, skills and attitudes • KSAs • Balance between • Deconstruction (microtasks) • Integration (complex performance)

  10. Milestones • 5 levels of proficiency • Novice (entry level med school graduate) • Beginner • Competent • Proficient (graduating resident) • Expert (advanced practitioner)

  11. Assessment under New Accreditation System • Continuous process • OK for trainees to meet expectations ahead of schedule • Failure to meet milestones may trigger further assessment, intervention, remediation

  12. Assessment under New Accreditation System • Integrated set of complex performance expectations • Personal and professional development • Done with (not to) residents • Reported every 6 months • Assessment of program effectiveness

  13. Assessment under New Accreditation System • Integrated set of complex performance expectations • Personal and professional development • Done with (not to) residents • Assessment of program effectiveness

  14. Example from Internal Medicine

  15. EM Milestones • Aligned with core competencies • Specialty-specific vs. universal skills • Parallels development of ABEM Initial Certification criteria • Linked to “Physician Tasks” (Model of Clinical Practice of EM)

  16. EM Milestones under New Accreditation System • Roll out of pilot in 2013 • One of 7 “early adopter” specialties • emergency medicine • internal medicine • neurosurgery • orthopedics • pediatrics • radiology • urology