Correlations between Accreditation Council for Graduate Medical Education Obstetrics and Gynecology Milestones and American Board of Obstetrics and Gynecology qualifying examination scores: an initial validity study

Bienstock, Jessica L.; Shivraj, Pooja; Yamazaki, Kenji; Connolly, Anna Marie; Wendel, George D.; Hamstra, Stanley J.; Holmboe, Eric S.

doi:10.1016/j.ajog.2020.10.029

Cited by 11 publications

(15 citation statements)

References 7 publications

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“…8,9 Supporting that usage, the milestones are associated with clinical progression in residency training [9][10][11][12][13][14] as well as with board-certifying exam performance. 10,[15][16][17] However, milestones ratings have not been demonstrated to have an association with early career patient outcomes in any specialty. Whether these ratings can effectively measure readiness for unsupervised practice is a key question as competency-based reform efforts gain momentum across the medical education system.…”

Section: Editor's Note: a Commentary By Kb Montgomery And B Lindeman ...mentioning

confidence: 99%

Association of Surgical Resident Competency Ratings With Patient Outcomes

et al. 2023

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Purpose Accurate assessment of clinical performance is essential to ensure graduating residents are competent for unsupervised practice. The Accreditation Council for Graduate Medical Education milestones framework is the most widely used competency-based framework in the United States. However, the relationship between residents’ milestones competency ratings and their subsequent early career clinical outcomes has not been established. It is important to examine the association between milestones competency ratings of U.S. general surgical residents and those surgeons’ patient outcomes in early career practice. Method A retrospective, cross-sectional study was conducted using a sample of national Medicare claims for 23 common, high-risk inpatient general surgical procedures performed between July 1, 2015, and November 30, 2018 (n = 12,400 cases) by nonfellowship-trained U.S. general surgeons. Milestone ratings collected during those surgeons’ last year of residency (n = 701 residents) were compared with their risk-adjusted rates of mortality, any complication, or severe complication within 30 days of index operation during their first 2 years of practice. Results There were no associations between mean milestone competency ratings of graduating general surgery residents and their subsequent early career patient outcomes, including any complication (23% proficient vs 22% not yet proficient; relative risk [RR], 0.97, [95% CI, 0.88–1.08]); severe complication (9% vs 9%, respectively; RR, 1.01, [95% CI, 0.86–1.19]); and mortality (5% vs 5%; RR, 1.07, [95% CI, 0.88–1.30]). Secondary analyses yielded no associations between patient outcomes and milestone ratings specific to technical performance, or between patient outcomes and composites of operative performance, professionalism, or leadership milestones ratings (P ranged .32–.97). Conclusions Milestone ratings of graduating general surgery residents were not associated with the patient outcomes of those surgeons when they performed common, higher-risk procedures in a Medicare population. Efforts to improve how milestones ratings are generated might strengthen their association with early career outcomes.

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Section: Editor's Note: a Commentary By Kb Montgomery And B Lindeman ...mentioning

confidence: 99%

Association of Surgical Resident Competency Ratings With Patient Outcomes

et al. 2023

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“…Recent studies provide preliminary insights from 2 different specialties that found stronger correlations between MK milestone subcompetencies and performance on high-stakes multiple-choice certification examinations than between non-MK subcompetencies and performance on these examinations. 13,14 This suggests that program directors could aggregate their residents' MK milestone ratings to infer the residents' likelihood of passing certification examinations.…”

Section: Discussionmentioning

confidence: 99%

“…Several validity studies on the milestones have been conducted regarding content, 4–6 internal structure, 8 response process, 9–11 and relations to other variables. 12–14 The present study demonstrates a validation process for the internal structure of the obstetrics and gynecology (OBGYN) milestones.…”

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confidence: 93%

An Empirical Investigation Into Milestones Factor Structure Using National Data Derived From Clinical Competency Committees

2022

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“…46 Although there has been some work to provide validity evidence for other milestones, 47 this is often limited to a description of the progression of residents within the milestones framework or performance on certification examinations, but not to broader educational outcomes after graduation. [48][49][50] Despite the early promise for competencybased education to result in potential time variable training, 51 the shared mental model for the developmental progression of a neurology resident remains mainly time based. 52 One study of multiple pediatric residency programs showed that the milestones were more sensitive to differences between programs than to differences between learners, 53 and an earlier validity study of internal medicine milestones reported that the differences in overall program milestones scores could be correlated with other program characteristics such as certification examination pass rate or program director experience.…”

Section: Current State Core Elements Of Neurologic Educationmentioning

confidence: 99%

Neurology Education in 2035

Moeller

Salas

2023

Neurology

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In the last decade, there have been dramatic changes in all aspects of neurologic care, and along with this, neurology education has transformed. These changes have affected all aspects of education across the educational continuum, including learners, teachers, educators, content, delivery methods, assessments and outcomes. Health systems science, health humanities, diversity, equity and inclusion and health disparities are becoming core components of neurology curricula, and in the future, will be integrated into every aspect of our educational mission. The ways in which material is taught and learned have been influenced by technological innovations and a growing understanding of the science of learning. We forecast that this trend will continue, with learners choosing from an array of electronic resources to engage with fundamental topics, allowing front-line clinical teachers to spend more time supporting critical reasoning and teaching students how to learn. There has been a growing differentiation of educational roles (i.e. teachers, educators and scholars). We forecast that these roles will become more distinct, each with an individualized pattern of support and expectations. Assessment has become more aligned with the work of the learners, and there are growing calls to focus more on the impact of educational programs on patient care. We forecast that there will be an increased emphasis on educational outcomes and public accountability for training programs. In this article we reflect on the history of medical education in neurology and explore the current state in order to forecast the future of neurology education, and discuss ways in which we can prepare.

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Correlations between Accreditation Council for Graduate Medical Education Obstetrics and Gynecology Milestones and American Board of Obstetrics and Gynecology qualifying examination scores: an initial validity study

Cited by 11 publications

References 7 publications

Association of Surgical Resident Competency Ratings With Patient Outcomes

Association of Surgical Resident Competency Ratings With Patient Outcomes

An Empirical Investigation Into Milestones Factor Structure Using National Data Derived From Clinical Competency Committees

Neurology Education in 2035

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