milestones: 1.0, 2.0, and oh my! - ahme
TRANSCRIPT
10/2/2020
1
Milestones: 1.0, 2.0, and Oh My!
Laura Edgar, EdDVice President, Milestones Development
©2020 ACGME
Disclosure
• Full-time employee of ACGME
2
©2020 ACGME
Milestones
• A milestone is a significant point in development
• Milestones follow an individual’s developmental trajectory across a range of knowledge, skills, and attitudes
3
1
2
3
10/2/2020
2
©2020 ACGME
4
©2020 ACGME
Milestones were designed to be formativeA repository for other assessments
Not every Milestone can or should be evaluated on every rotation Not everything that should be evaluated is included in the Milestones
Milestones as Assessments
Milestone Evaluation
ITE
DOMSF
5
©2020 ACGME
Differences
Patient Care and Medical Knowledge have two options outside of the levels:• Not yet completed Level 1/Critical deficiencies • Not yet rotated/Not yet assessable
6
4
5
6
10/2/2020
3
©2020 ACGME
What changed?
7
©2020 ACGME
Supplemental Guide
Examples for Levels 1-5Assessment methodsResources
8
©2020 ACGME
Supplemental Guide
9
7
8
9
10/2/2020
4
©2020 ACGME
Supplemental Guide
Review the Milestones and Supplemental guide with your CCC
• Program’s expectations at each level• Assessment tool(s) you will use• Rotations each will be assessed
Your CCC should do a shared mental model exercise
10
©2020 ACGME
Supplemental Guide - Map
11
©2020 ACGME
Milestones 2.0
12
10
11
12
10/2/2020
5
©2020 ACGME
Identify and address obstacles a) Be open and listen to concernsb) Answer what you can – Call ACGME if notc) For content – remind them that their specialty
community created them
Implementing Changes
13
©2020 ACGME
Identify programs who are doing the change wella) Let your champions demonstrateb) Offer additional faculty developmentc) Begin development of new shared mental model
Implementing Changes
14
©2020 ACGME
Share success stories and document what strategies worked best
a) Each specialty should have its own championb) Share experiences at GME meetingsc) Share experiences at specialty meetings
Implementing Changes
15
13
14
15
10/2/2020
6
©2020 ACGME
Implementing Changes
16
©2020 ACGME
Using Milestone Data
17
©2020 ACGME
Self-Assessment Leads to Learning Plans• Milestones are an ideal way for residents and fellows
to monitor their professional progress• Faculty can also benefit from self-assessment with
the Milestones• Requires Purposeful and Deliberate self-review and
practice to continue growth
18
16
17
18
10/2/2020
7
©2020 ACGME
Family Medicine 2019
Using Milestones Data: Boxplots
19
©2020 ACGME
Milestones Trajectories
n = 270(20%)
n = 1066(80%)
Jul ‘13 Entrance
1st Assessment Graduation
N=1336
How much risk at this point in training?
20
©2020 ACGME
1st year 2nd year 3rd yearCut-offs: Levels Mid-Year 1 Year-End 1 Mid-Year 2 Year-End 2 Mid-Year 3
% Not Achieving Level 4 At Graduation <= Lev5.0<= Lev4.5<= Lev4.0<= Lev3.5 17.5 18.3 26.9<= Lev3.0 17.3 17.4 18.8 24.7 52.4<= Lev2.5 17.4 18.4 26.2 51.5 81.0<= Lev2.0 18.5 22.8 39.5 62.6 88.1<= Lev1.5 22.4 32.9 48.5 90.9<= Lev1.0 27.8 38.1= Lev0.0 25.2
PPV Matrix: Example
21
19
20
21
10/2/2020
8
©2020 ACGME
Dermatology - PC01
22
©2020 ACGME
Surgery PPV – MK01
23
©2020 ACGME
Simply ask “why?”
• Is further assessment or clarification needed?• Or is this just simply an expected pattern in your program?
• Could such a realization help guide an individualized learning plan or need for a formal remediation plan?
The purpose of Milestones analytics is to facilitate professional growth and improvement
If You See These Patterns…
24
22
23
24
10/2/2020
9
©2020 ACGME
• ACGME did not require submission of Milestones in spring 2020
• More than 80% of programs did submit• National Report will show mid-year data
Impacts of COVID
25
©2020 ACGME
Where do I find...?
26
©2020 ACGME
• Are you aware of the Milestones resources available from ACGME?
• Resident-Fellow Guidebook for Milestones?• Annual Milestones National Report?
Resources
27
25
26
27
10/2/2020
10
©2020 ACGME
28
©2020 ACGME29
©2020 ACGME
Distance Learning
30
28
29
30
10/2/2020
11
©2020 ACGME31
©2020 ACGME
32
©2020 ACGME
33
31
32
33
10/2/2020
12
©2020 ACGME
34
©2020 ACGME
Here to help
Milestones:[email protected] [email protected]
35
34
35