Internal Medicine Milestones

Abstract

The Milestones are designed only for use in evaluation of resident physicians in the context of their participation in ACGME-accredited residency or fellowship programs. The Milestones provide a framework for the assessment of the development of the resident physician in key dimensions of the elements of physician competency in a specialty or subspecialty. The Milestones represent neither the entirety of the dimensions of the 6 domains of physician competency nor are they designed to be relevant in any other context.

Preliminary Validity Evidence for a Milestones-Based Rating Scale for Chart-Stimulated Recall

“…An iterative process of blueprinting CSR to the ACGME Internal Medicine Milestones was used to establish content validity (provided as online supplemental material). 9,16 Two IM faculty and 2 chief residents independently reviewed the 22 subcompetencies and 139 associated milestones. Eleven subcompetencies and 27 milestones were identified as measurable by CSR (see TABLE 1 for a sample item).…”

“…7 Expert-derived frameworks of clinical competence, like the Accreditation Council for Graduate Medical Education (ACGME) Milestone Projects, may be helpful in defining level-specific performance for rating scales. 8,9 Although preliminary studies have shown advantages to using Milestones-Based Rating Scales (MBRSs) over SRSs in differentiating among levels of learners, 10,11 there is insufficient validity evidence to recommend conversion to MBRS for all assessments. Despite the paucity of studies to support the use of milestones for rating forms, many residency management software systems provide program directors with the option to create assessment forms with milestones that are used verbatim as anchors on forms.…”

Use of Milestones and Development of Entrustable Professional Activities in 2 Hematology/Oncology Training Programs

“…At the time, we did not yet have the IM Subspecialty Reporting Milestones and the 22 core IM Reporting Milestones were just published. 7 Fortunately, our core IM program had created a continuity clinic evaluation template by using the original 142 developmental milestones published by the American Board of Internal Medicine and the ACGME. 8 We modified this template to include 2 to 3 milestones supporting each of the 6 core competencies for each tool developed.…”

A Faculty Development Program to Reduce Rater Error on Milestone-Based Assessments

“…[5][6][7][8] In 2009 a Milestone Task Force of the Accreditation Council for Graduate Medical Education and American Board of Internal Medicine (ABIM) published its draft Milestone document, consisting of a list of 142 ''curricular'' Milestones (which are distinct from the 22 internal medicine reporting Milestones). 9,10 These curricular Milestones represent specific, observable skills in the 6 competencies residents should demonstrate at each level of training during the 3 years of training. Although program directors have developed new assessment tools based on the Milestones, little is known about how best to educate and support faculty in using the new tools.…”