Milestones

Jennifer Gould, MDProgram Director, Diagnostic

Radiology

Our Program

• Accredited for 72 residents• Over 80 faculty• 8 Sections• Multiple locations

Our Milestones

• 12 Sub-Competencies• “Lumpers”• Programs designate items to be measured for

three of the sub-competencies– Basic/intermediate/advanced– Common/Uncommon

Our Milestones

• For the CCC (6)– Patient Care and Technical Skills (2)– Medical Knowledge (2)– Professionalism (1)– Interpersonal and Communication Skills (1 of 2)

Our Milestones

• For the “office” (6)– Systems-Based Practice (2)– Practice-Based Learning and Improvement (3)– Interpersonal and Communication Skills (1 of 2)

“Define your own”

• Each CCC member asked to designate items• List compiled and condensed• CCC members identified evaluation method

Rotation Specific Items

• Check lists• Evaluation of observed procedures• Procedure logs• Imaging quizzes

Resident Development

• Early meetings with discussion– Transparency

• Asked them to fill out Milestones for themselves

• Gave them as much responsibility as possible

Clinical Competency Committee

• No requirements other than the common program requirements

• Our Program– I chair the committee– Asked for a minimum 1 member of each section– Meet at least every 6 months– E-mail communication for updates, etc.

Clinical Competency Committee

• Each member tasked with– Identifying the “define your own” items– Designing a reliable way of measuring those– Keeping records– Monitoring residents– Collecting information from colleagues

Meeting format

• Meeting date scheduled far in advance• Everyone was expected to show up prepared– Data from evaluations

Meeting format

• Updates/announcements• Who are we concerned about?– That “funny feeling”

• Discussion of the residents

Discussion by Milestone

• Do the math

In the background

• The “office” took care of 6 of the Milestones– ICS, PBLI, SBP– Grading quizzes– Collecting forms– Designating Milestone achievement

CCC meeting

• Prelim meeting June 2013– Is our planned format going to work?– Establish baseline

• First official meeting Dec 2013

Successes

• Early discussions with the residents– Milestones are coming– Milestones are here– This is where you find your Milestone report

• Residents rating themselves on the Milestones• Make them responsible– More stuff is getting turned in!– Comments indicate missing paperwork

Successes

• Wrote several quizzes and developed new evaluation methods

• Uploaded to their learning portfolios• We survived the first official meeting!

Challenges

• Some residents were a little surprised– Our rotation evaluators need improvement

• New assessments• Some assessments still to come…• Faculty training - ?• The questions that I can’t answer