Reporting Achievement of Medical Student Milestones to Residency Program Directors: An Educational Handover

Abstract

An EM milestone-based, post-Match assessment that uses existing assessment data is feasible and may be effective for communicating competency-based information about medical school graduates to receiving residency programs. Next steps include further aligning assessments with competencies, determining the benefit of such an assessment for other specialties, and articulating the national need for an effective educational handover tool between undergraduate and graduate medical education institutions.

Emergency Medicine Resident Orientation: How Training Programs Get their Residents Started

“…Deficiencies could be identified and remediated earlier, or customized learning plans based on milestone achievement could be developed. Competency-based assessment that document milestone progress or measure attainment of “Entrustable Professional Activities” are being developed and are beginning to surface in the literature 7,15,16. However, when assessments should be conducted and who should be responsible for assessment, whether it should be UME or GME programs, are questions that remain unanswered 7.…”

Promoting Achievement of Level 1 Milestones for Medical Students Going into Emergency Medicine

“…A fully functional electronic assessment system for recording and saving direct observation data has been tested and implemented. And finally, the program leaders are implementing a “feed-forward” process to residency directors modeled after that described by Sozener 14 so that residency programs can make practical use of our efforts to document student performance during medical school.…”

Educational Handoffs from Medical School to Residency: an Emerging Opportunity

“…Wancata et al also at the University of Michigan, piloted a similar instrument with rising general surgery interns, mapping third and fourth year performance metrics to general surgery milestones. This too proved feasible, though program director satisfaction and feedback were not reported [Sozener, et al, 2016]. Others have proposed an educational handoff system similar to handoffs in patient care, where medical schools summarize the competencies of graduating students, their performance, and any actionable items going forward [Warm, et al, 2016].…”

“…Sozener and colleagues at the University of Michigan piloted a milestone-based educational handoff for rising emergency medicine (EM) interns. Using milestone data collected toward the end of medical school in EM-related rotations to create performance evaluations, they shared these evaluations with several program directors, with positive preliminary responses regarding utility and usability [Sozener, et al, 2016]. Wancata et al also at the University of Michigan, piloted a similar instrument with rising general surgery interns, mapping third and fourth year performance metrics to general surgery milestones.…”

“…Many have raised concerns about the utility and reliability of the MSPE to communicate students' skills and educational needs anticipated during residency, purposes that it is not actually intended for [Green, et al, 2012). Criticisms of the traditional Dean's letter include that it is (a) not standardized, (b) susceptible to "code" language describing the quality of an applicant, (c) subjective, (d) labor intensive, (e) completed almost a year before internship, and (f) does not necessarily incorporate the large amounts of data currently collected regarding medical student performance [Green, et al, 2012;Sozener, et al, 2016].…”