Essential component of NAS are the MILESTONES

Basis is to track development in the 6 competencies

Dreyfus Model:- Novice

- Advanced beginner

- Competent

- Proficient

- Expert

- Master

Milestones

RRC

Boards

P.D.’s

Residents

Milestones

Milestones Developed By

Develop by December 2012

Submission to ACGME 2013 & 2014

Milestones Will Supplement, Not Replace Existing Assessment Tools

Timeline:

Milestones

Could you present your experience with the Milestones?

The Orthopaedic Surgery Milestones

I. Martin Levy, MDProgram Director

Professor of ClinicalOrthopaedic Surgery

The Milestones

are ComingHere

The only thing we have to fear is FEAR ITSELF

…and spiders

…and maybe the milestones

So we gathered our Chiefs of Service.

Like everyone else, we took our toolbox and started to figure out ways to recognize a competent resident.

We developed goals and objectives for each service.

This was not the easy part.

But we ended up with a handbook.

While doing our G&O’s, we started playing with technical milestones. We called them Index Procedures. We began using these Index Procedures as a way to assess achievement of independence.

I brought these IP’s to CORD’s Technical Competency Committee. During these discussions I became aware of the ACGME Milestone Project.

“A good plan violently executed now,is better than a perfect plan executed next week.” George S. Patton Jr.

While not ecstatic over the knowledge that index procedures were going to morph into the more complex milestones, COS familiarity with IP’s and G&O’s made the transition less painful…for me.

Dr. Nasca wrote his

article, NAS became a

household word and the the Milestone Project

arrived at our doorstep.

We were fortunate that the Orthopaedic Knowledge Base and Patient Care milestones were prescriptive and organized by subspecialty.

Each Chief of Service was

asked to review their

service specific

milestones and discuss

feasibility.

They have successfullycreated a curriculum that supports the knowledge base and develops the required surgical techniques and clinical skills.

• Gets a real time review • For applicable Milestones only• And these are uploaded

Each resident on a service

Clinical Competency Committee (C.C.C.)

Core faculty

Program director-

Chief resident

Include

Function

Function

Evaluate milestones & early warning

Track progress of residents

Faculty development

Reduce potential bias

Performance measure

Decision making by multiple people

Evaluate 360° assessments

Purpose

So we identified our Clinical Competency Committee.

The C.C.C. was thrilled.

From the C.C.C. each resident receives:

• Summative evaluation• Twice a year• And these are uploaded

At this early stage, and with what is at stake, I believe the only way to insure reliable input, is by meeting regularly with my Chiefs of Service.

Thank you