Mapping Direct Observations From Objective Structured Clinical Examinations to the Milestones Across Specialties

Baker-Genaw, Kimberly; Kokas, Maria; Ahsan, Syed F.; Darnley-Fisch, Deborah; Drake, Sean; Goyal, Nikhil; Inamdar, Kedar; Moutzouros, Vasilios; Prabhakar, Deepak; Rolland, Laurie; Sangha, Roopina; Shreve, Maria E.; Woodward, Alan

doi:10.4300/jgme-d-15-00385.1

Cited by 4 publications

(3 citation statements)

References 14 publications

(15 reference statements)

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“…In the context of Milestones 2.0, the goal is to develop shared assessment tools that can be used across specialties to accurately evaluate skills. It is our belief that IMA can be used and applied to all specialties despite the appearance of the skill of breaking bad news in multiple milestone levels across the specialties [ 2 , 7 ]. As Milestones 2.0 develops more harmonized sub-competencies and sub-anchors, we propose that the IMA tool could be used to further evaluate breaking bad news as a skill commonly listed in the ICS and Prof competencies.…”

Section: Discussionmentioning

confidence: 99%

“… Milestones 2.0 emphasizes accurate evaluations, ideally through direct observational tools. Currently, no consistent process exists for summative and formative assessment of trainees regarding the skill of breaking bad news [ 2 – 4 ]. The Integrated Milestone Assessment (IMA) tool that we developed for breaking bad news would be a valuable addition to the Milestones 2.0 toolbox [ 3 ].…”

Section: Practice Pointsmentioning

confidence: 99%

Section: Practice Pointsmentioning

confidence: 99%

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Development of an integrated milestone assessment tool across multiple early-adopter programs for breaking bad news: a pilot project

Turner,

Gopakumar,

Minard

et al. 2024

BMC Med Educ

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Background The transition of the Accreditation Council for Graduate Medical Education (ACGME) to milestone assessment creates opportunities for collaboration and shared assessments across graduate medical programs. Breaking bad news is an essential communication skill that is a common milestone across almost every medical specialty. The purpose of this study was to develop and pilot an integrated milestone assessment (IMA) tool for breaking bad news using ACGME milestone criteria and to compare the IMA tool with the existing SPIKES protocol. Methods The IMA tool was created using sub-anchors in professionalism and interpersonal communication skills that are applicable to every specialty and to the ability to break bad news. Two cases of breaking bad news, designed to be “easy” and “intermediate” in difficulty, were used to assess basic skills in breaking bad news in first-year medical residents from six residency specialties. Eight standardized patients were trained to portray the cases in sessions held in November 2013 and May 2014. Standardized patients completed an assessment checklist to evaluate each resident’s performance in breaking bad news based on their use of the SPIKES protocol and IMA tool. Residents answered post-encounter questions about their training and comfort in breaking bad news. The association between SPIKES and IMA scores was investigated by simple linear regression models and Spearman rank correlations. Results There were 136 eligible medical residents: 108 (79.4%) participated in the first session and 97 (71.3%) participated in the second session, with 96 (70.6%) residents participating in both sessions. Overall, we were able to identify residents that performed at both extremes of the assessment criteria using the integrated milestone assessment (IMA) and the SPIKES protocol. Interestingly, residents rated themselves below “comfortable” on average. Conclusion We developed an integrated milestone assessment (IMA) that was better than the SPIKES protocol at assessing the skill of breaking bad news. This collaborative assessment tool can be used as supplement tool in the era of milestone transformation. We aim assess our tool in other specialties and institutions, as well as assess other shared milestones across specialties.

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Section: Discussionmentioning

confidence: 99%