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Measuring resident progress: Competency milestones in internal medicine.


Caverzagie K. — Henry Ford Hospital

Aagaard E. — University of Colorado

Green M. — Yale University

Holmboe ES. — American Board of Internal Medicine

Smith C. — Lankenau Hospital

Chick D. — University of Michigan

Presented: 14th Ottawa Conference, May 2010

Background: The implementation of the ACGME Outcomes Project, including the six Core Competencies, signaled a transition to competency-based education and training (CBET) for graduate medical education. The goal of CBET is for trainees to demonstrate achievement of educational outcomes necessary for advancement.

Summary of Work: The ACGME and ABIM convened a task force of internal medicine educators and stakeholders, who created a comprehensive set of developmental milestones using the ACGME competencies as their framework. Each milestone was framed as an observable behavior in order to facilitate the criterion-based assessment of competence and to promote understanding and recognition of expected behaviors by both trainees and faculty. The task force sought feedback on the utility of the milestones via a direct survey of program directors and graduating trainees, through a national workshop and from collaborative groups.

Summary of Results: A total of 251 respondents have completed the milestones survey and numerous others have participated in workshops where formative feedback was provided. Program directors and trainees feel the milestones help them to better understand the expected behaviors of a competent trainee ready to enter into independent practice. They also feel that they have the potential to provide both a platform for the meaningful assessment of trainee competence and a mechanism to identify trainees who are not appropriately progressing towards competence in order to begin early remediation. The milestones may also provide a starting point for curricular revision and evaluation system reform. There is a need for continued engagement of internal medicine stakeholders and feedback is still being solicited. Leadership from the ACGME and ABIM continue to be engaged in the milestones process.

For more information about this presentation, please contact Research@abim.org.