Educational Milestone Development in the First 7 Specialties to Enter the Next Accreditation System

Abstract

Initial evidence for validity emerges from the development processes and the resulting milestones. Further advancing a validity argument will require research on the use of milestone data in resident assessment and program accreditation.

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

“…In concert with the ACGME and the relevant American Board of Medical Specialties (ABMS) specialty board, each specialty convened a Milestone Working Group to develop specialtyspecific milestones. 4 Milestones were developed through working groups' expert consensus, with extensive feedback from stakeholders and subsequent revisions. 4 Working groups used the 6 ACGME competencies and the Dreyfus model of skill acquisition as theoretical frameworks.…”

“…4 Milestones were developed through working groups' expert consensus, with extensive feedback from stakeholders and subsequent revisions. 4 Working groups used the 6 ACGME competencies and the Dreyfus model of skill acquisition as theoretical frameworks. [4][5][6] In addition, many used literature reviews to inform the development of milestone sets.…”

“…4 Working groups used the 6 ACGME competencies and the Dreyfus model of skill acquisition as theoretical frameworks. [4][5][6] In addition, many used literature reviews to inform the development of milestone sets. [7][8][9][10] However, many subspecialty fellowships did not develop their own milestone sets, and instead share milestone sets.…”

The Psychiatry Milestones: New Developments and Challenges

“…Second, although there were specialty-specific requirements and common program requirements of the ACGME, there was no demand for a high degree of specificity of measurable, individual benchmarks for evaluation. Most programs used global assessments, such as 360°evaluations, and the requirements for construct validity and current milestone-like developmental assessment were largely neglected [17].…”

What the ACGME’s Next Accreditation System Means to You

“…In response, the Accreditation Council on Graduate Medical Education (ACGME) is introducing the Next Accreditation System (NAS) for better documentation of residency programs and resident performance [5,8]. As part of this introduction, all specialties will incorporate the six general competencies (medical knowledge, systems-based practice, patient care, communication and interpersonal skills, professionalism, and practicebased learning and improvement) into ''milestones'' to gauge resident performance at various levels of training.…”