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TRANSCRIPT
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Milestones & Evaluation Tools
Professional Development Workshop
Brandy Church, MA, Pam Royston, PhD, and Heidi Kromrei, PhD
https://www.acgme.org/acgmeweb/Portals/0/PDFs/NAS/KeyDatesPhase1specialties.pdf
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https://www.acgme.org/acgmeweb/Portals/0/PDFs/Milestones/InternalMedicineMilestones.pdf
http://www.acgme.org/acgmeweb/Portals/0/PDFs/Milestones/MilestonesFAQ.pdf
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https://www.acgme.org/acgmeweb/Portals/0/PDFs/Nasca-Community/FAQs.pdf
https://www.acgme.org/acgmeweb/Portals/0/PFAssets/2013-PR-FAQ-PIF/140_internal_medicine_07012013.pdf
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Creating a Common Language
Competency-Based Education:Introduction to the Milestones
Brandy Church, MA
Session Objectives
Traditional Model
Frenk J, et al. (2010). Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet, 376(9756): 1923-1958.
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Elements of Model
Traditional
Driving Force for Curriculum Content
Driving Force for Process Teacher
Responsibility for content Teacher
Goal of Educational Encounter Knowledge acquisition
Timing of Assessment Emphasis on summative
Program Completion Fixed Time
Carraccio, C, Wolfsthal, SD, Englander, R, Ferentz, K & Martin, C. (2002). Shifting paradigms: from Flexner to competencies. Academic Medicine, 77(5): 361-367.
Is the system-in-placemeeting our current
needs?
Institute of Medicine (IOM). 2001. Crossing the quality chasm.. Washington, D.C: National Academy Press.
Institute of Medicine (IOM). 2014. Graduate medical education that meets the nation’s health needs. Washington, DC: The National Academies Press.
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Carraccio, C, Wolfsthal, SD, Englander, R, Ferentz, K & Martin, C. (2002). Shifting paradigms: from Flexner to competencies. Academic Medicine, 77(5): 361-367.
“Medical education is at a crossroads: those who teach medical students and residents much choose whether to continue in the direction established over a hundred years ago or take a fundamentally different course, guided by contemporary innovation and new understandings about how people learn.”
Cooke, M, Irby, DM, O’Brien, BC. (2010). Calls for reform of medical education by Carnegie Foundation for the Advancement of Teaching: 1910 and 2010. Academic Medicine, 85(2): 2201-227.
John R. Potts, III, MD
HCPro. (December 2014). Transitioning to a single accreditation system for GME. Residency Program Alert, 2(12): pg. 5.
“Learn a new culture
and a new language”
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Competency Based
Frank JR, Snell LS, ten Cate O. et al. Competency-based medical education: theory to practice. Med Teach, 2010; 32: 638-645.
Competency Based
Frank JR, Snell LS, ten Cate O. et al. Competency-based medical education: theory to practice. Med Teach, 2010; 32: 638-645.
Traditional Competency‐Based
Driving Force for Curriculum
Content Outcomes
Driving Force for Process Teacher Learner
Responsibility for Content
Teacher Learner & Teacher
Goal of Educational Encounter
Knowledge acquisition Knowledge application
Timing of Assessment Emphasis on summative Emphasis on formative
Program Completion Fixed Time Variable Time
Carraccio, C, Wolfsthal, SD, Englander, R, Ferentz, K & Martin, C. (2002). Shifting paradigms: from Flexner to competencies. Academic Medicine, 77(5): 361-367.
Elements of Models
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Vocabulary
The International CBME Collaborators, 2009
Competency Defined
Frank JR, Snell LS, ten Cate O. et al. Competency-based medical education: theory to practice. Med Teach, 2010; 32: 638-645.
Competent Defined
Simulation
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Ten Cate, O. S. (2010). Medical competency: the interplay between individual ability and the health care environment. Medical Teacher, 669-675.
Competence Defined
Optimal Medical Results
Potential Outcomes
Situation
Factors
Putting It All Together
Competency
Competent
Competence
Wiggins, G. & McTighe, J. (2005). Understanding by design (2nd Ed.). Alexandria, VA: Association for Supervision and Curriculum Development.
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Dreyfus Model
Novice
Advanced Beginner
Competent
Proficient
Expert
Dreyfus, SE, Dreyfus, HL. (1980). A five-stage model of the mental activities involved in directed skill acquisition. Washington, DC: Storming Media.
Major changes
Curriculum
What do we need?
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Birth of the Milestone Project
What Are Milestones?
http://www.acgme.org/acgmeweb/tabid/430/ProgramandInstitutionalAccreditation/NextAccreditationSystem/Milestones.aspx
Milestone Levels
Level Level Level Level
Milestones are progressive – there is no prescribed speed.
Levels do not correspond to PGY or year in program.
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Next Steps
Evaluation
Complete an evaluation of my presentation at
https://scs.msu.edu/eval/
Thank you very much for your feedback!
Specialty Workgroups
Familiarizing Yourself with Your Specialty’s Milestones
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ReferencesAccreditation Council for Graduate Medical Education (2014). http://www.acgme/.org
Carraccio, C, Wolfsthal, SD, Englander, R, Ferentz, K & Martin, C. (2002). Shifting paradigms: from Flexner to competencies. Academic Medicine, 77(5): 361-367.
Cooke, M, Irby, DM, O’Brien, BC. (2010). Calls for reform of medical education by Carnegie Foundation for the Advancement of Teaching: 1910 and 2010. Academic Medicine, 85(2): 2201-227.
Dreyfus, SE, Dreyfus, HL. (1980). A five-stage model of the mental activities involved in directed skill acquisition. Washington, DC: Storming Media.
Frank JR, Snell LS, Ten Cate O. et al. Competency-based medical education: theory to practice. Med Teach, 2010; 32: 638-645.
Frenk J, et al. (2010). Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet, 376(9756): 1923-1958.HCPro. (December 2014). Transitioning to a single accreditation system for GME. Residency Program Alert, 2(12): pg. 5.
Institute of Medicine (IOM). 2001. Crossing the Quality Chasm. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, D.C: National Academy Press.
Institute of Medicine (IOM). 2014. Graduate medical education that meets the nation’s health needs. Washington, DC: The National Academies Press.
Ten Cate, O. S. (2010). Medical competency: the interplay between individual ability and the health care environment. Medical Teacher, 669-675.
Wiggins, G. & McTighe, J. (2005). Understanding by design (2nd Ed.). Alexandria, VA: Association for Supervision and Curriculum Development.