OPEN ACCESSSeptember 16, 2014

Faculty Development Series on Assessment in Graduate Medical Education: The Milestone Project


    This resource is a set of PowerPoint slides designed for the purpose of faculty development. The slides are intended for presentation by a residency program director (or designee) in a didactic or workshop setting for the purpose of introducing faculty to the Milestone Project and its utility in assessing resident performance. This presentation is the second of a six-part series that were commissioned by the Program Directors Committee of the American Board of Pediatrics based on their publication entitled Assessment in Graduate Medical Education: A Primer for Pediatric Program Directors. This case-based presentation begins with a perspective of how residency programs and their trainees have been assessed over the past decade. It then explores and demonstrates problems with traditional methods of assessment using an interactive, non-medical video example and a typical assessment tool. The presentation then introduces the concept of The Pediatrics Milestone Project as one of the changes implemented with the Next Accreditation System. It reviews the origins of the Milestones Project, how it is framed by the existing competencies, and its utility in improving resident assessment. The module continues with a video where the participants are asked to assess the performance of the learner using traditional methods, followed by Milestone methods. At the conclusion, the concepts of the Clinical Competency Committee and Entrustable Professional Activities are introduced. In our experiences using this material, the authors have found that participants are quick to acknowledge the issues with traditional evaluation tools after viewing both the non-medical and medical video scenarios. The effectiveness of assessment with narrative anchors is also readily evident when these tools are used instead of the traditional ones. The participants valued the experience of rating themselves on several competencies, since some found that, even as experienced independent practitioners, they had not always attained the skills described in “Milestone 5.” In this way, they felt justified in placing early learners on the lower Milestones, and did not feel the pressure to “inflate” them higher. In terms of implementing the Milestone Project, the participants, who were mainly core faculty and rotation directors, were supportive of changing the existing evaluation tools to better inform the Milestone process.

    Educational Objectives

    By the end of this session, learners will:

    1. Review the history of resident assessment.

    2. Identify problems with the traditional assessment methods.

    3. Understand the origins and goals of the Milestone Project.

    4. Understand the Milestone process flow and how it is framed by the current competency domains.

    5. Apply a variety of assessment tools to case scenarios to determine effectiveness of each.

    6. Define the Clinical Competency Committee and Entrustable Professional Activities as they relate to the Milestone Process.