minimally invasive gynecology milestones these milestones ... · level 2: the fellow is advancing...

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Minimally Invasive Gynecology Milestones These milestones have been developed to evaluate the ongoing progress of trainees in the Fellowship in Minimally Invasive Gynecology. The milestones aim to provide a framework for assessment of the essential skills and knowledge expected of a participant graduating from the fellowship and aid in the identification of any surgical or educational deficiencies with ample time for remediation. These milestones are not designed to cover all aspects of benign gynecologic surgery, but rather to help ensure that fellows graduating from each program will achieve competency with key surgical and clinical skills. These Milestones are not designed to be relevant in any other context. Committee/Working Group Jubilee Brown Anne Marie Connoly Noah Rindos Mandy Yunker

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Page 1: Minimally Invasive Gynecology Milestones These milestones ... · Level 2: The fellow is advancing and is performing at mid-fellowship level Level 3: The fellow has advanced and is

MinimallyInvasiveGynecologyMilestones

ThesemilestoneshavebeendevelopedtoevaluatetheongoingprogressoftraineesintheFellowshipinMinimallyInvasiveGynecology.Themilestonesaimtoprovideaframeworkforassessmentoftheessentialskillsandknowledgeexpectedofa

participantgraduatingfromthefellowshipandaidintheidentificationofanysurgicaloreducationaldeficiencieswithampletimeforremediation.Thesemilestonesarenotdesignedtocoverallaspectsofbenigngynecologicsurgery,butrathertohelpensurethatfellowsgraduatingfromeachprogramwillachievecompetencywithkeysurgicalandclinicalskills.TheseMilestonesarenot

designedtoberelevantinanyothercontext.

Committee/WorkingGroupJubileeBrown

AnneMarieConnolyNoahRindosMandyYunker

Page 2: Minimally Invasive Gynecology Milestones These milestones ... · Level 2: The fellow is advancing and is performing at mid-fellowship level Level 3: The fellow has advanced and is

Milestonereporting

Themilestonesareintendedtobeusedbyfellowshipprogramstoaidwithsemi-annualfellowreviewsandwithreportingtoAAGL.Milestonesareknowledge,skills,attitudes,andotherattributesorganizedinadevelopmentalframeworkfromlesstomoreadvanced.Theyaredescriptorsandtargetsforfellowperformanceasafellowmovesfromentryintofellowshipthroughgraduation.Theattributesmeasuredincludegynecologicknowledge,surgicalskills,providerattitude,andadditionalattributesexpectedoffellowspursuingadvancedtraininginMinimallyInvasiveGynecology.Foreachperiod,reviewandreportingwillinvolveselectingmilestonelevelsthatbestdescribeafellow’scurrentperformanceandattributes.Milestonesarearrangedintonumberedlevels.TrackingfromLevel1toLevel4issynonymouswithmovingfromnovicetoexpertinthesubspecialty.Eachmilestoneiscomprisedoffourlevels,rangingfromnovicetoadvancedindependentpractitioner.Thesemilestoneswillcompriseonepartoftheaccreditationprocessforeachprogram,andaportionoftheevaluationforgraduationforeachfellow.Overeachsixmonthperiod,milestoneswillberecordedanddiscussedwiththefellowstoevaluatetheirsurgicalperformanceandattributes.Allfellowswillbeexpectedtoattainalevelof2inthemajorityofmilestonesbytheendoftheirfirstyearanda3bythetimetheyarepreparingtograduate.Selectionofalevelimpliesthatthefellowsubstantiallydemonstratesthemilestonesinthatlevel,aswellasthoseinlowerlevels,asfollows:Level1:Thefellowdemonstratesmilestonesexpectedofanincomingfellow/recentlygraduatedOBGYNresidentLevel2:Thefellowisadvancingandisperformingatmid-fellowshiplevelLevel3:Thefellowhasadvancedandismeetingthemajorityofmilestonestargetedforfellowship.(Leveldesignatedasgraduationtarget.)Level4:Thefellowhasadvancedbeyondperformancetargets,isabletofunctionmostlyindependently,andisdemonstrating“aspirational”goalsconsistentwithsomeoneinpracticeforseveralyears.

Page 3: Minimally Invasive Gynecology Milestones These milestones ... · Level 2: The fellow is advancing and is performing at mid-fellowship level Level 3: The fellow has advanced and is

Milestones

PC1:SurgicalCareofBenignGynecologicConditions—OpentechniquesLevel1 Level2 Level3 Level4IndependentlyselectsappropriateopenproceduresforbenigngynecologicconditionsProficientlyandsafelyperformsbenignstraightforwardgynecologicopenproceduresIdentifiessurgicalcomplicationsandappropriatelyusesintra-operativeconsultation

Effectivelyassistsincomplexopengynecologicprocedures(i.e.largeuterus,frozenpelvis)Recognizesanddevelopsmanagementstrategyforintra-operativecomplications,includingconversiontoanopenprocedure

Effectivelyperformscomplexopengynecologicprocedures,withsupervisionManagessurgicalcomplications,withsupervisionCollaborateswithandprovidessubspecialty-specificopensurgicalconsultationtoothermembersofthehealthcareteam,includingconversiontoanopenapproach,withsupervision

IndependentlyandproficientlyperformscomplexopengynecologicproceduresAnticipates,diagnoses,andindependentlymanagesintra-operativesurgicalcomplications,includingthedecisiontoconverttoanopenapproachIndependentlycollaborateswithandprovidessubspecialty-specificopensurgicalconsultationtoothermembersofthehealthcareteamAbletoinstructresidentsinpropersurgicaltechniqueswithminimalguidance

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

Page 4: Minimally Invasive Gynecology Milestones These milestones ... · Level 2: The fellow is advancing and is performing at mid-fellowship level Level 3: The fellow has advanced and is

PC2:SurgicalcareofBenignGynecologicConditions:MinimallyInvasiveTechniques-Laparoscopyand/orRoboticPlatformLevel1 Level2 Level3 Level4IndependentlyselectsappropriateminimallyinvasivesurgicalproceduresforbenigngynecologicconditionsProficientlyandsafelyperformsbasicminimallyinvasiveprocedures(i.e.tubalsterilization,adnexectomy,hysterectomy,diagnosticlaparoscopy)IdentifiesMIS-specificcomplicationsandappropriatelyusesintra-operativeconsultation

ProposesappropriateMISproceduresforcomplexbenigngynecologicconditionsEffectivelyassistsduringcomplexMISproceduresRecognizesanddevelopsmanagementstrategiesforMIS-relatedintraoperativecomplications

EffectivelyperformscomplexMISgynecologicprocedures,withsupervisionManagesMIS-relatedsurgicalcomplications,withsupervisionCollaborateswithandprovidessubspecialty-specificMISconsultationtoothermembersofthehealthcareteam,withsupervision

IndependentlyandproficientlyperformscomplexMISgynecologicproceduresAnticipates,diagnoses,andindependentlymanagesintra-operativeMIS-relatedcomplicationsIndependentlycollaborateswithandprovidessubspecialty-specificMISsurgicalconsultationtoothermembersofthehealthcareteamAppliesanevidence-basedapproachtoinnovativeandcomplexMIStreatmentplansforbenigngynecologicconditionsAbletoinstructresidentsinpropersurgicaltechniqueswithminimalguidance

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

Page 5: Minimally Invasive Gynecology Milestones These milestones ... · Level 2: The fellow is advancing and is performing at mid-fellowship level Level 3: The fellow has advanced and is

PC3:SurgicalcareofBenignGynecologicConditions:MinimallyInvasiveTechniques-VaginalApproachLevel1 Level2 Level3 Level4IndependentlyconsidersvaginalsurgicalapproachwhenappropriateforbenigngynecologicconditionsUnderstandsstepsofvaginalhysterectomyandperformsstraightforwardproceduresindependentlyIdentifiescomplicationsofvaginalhysterectomyandappropriatelyusesintra-operativeconsultation

ProficientlyandsafelyperformsstraightforwardvaginalhysterectomyEffectivelyassistsduringcomplexvaginalproceduresRecognizesanddevelopsmanagementstrategiesforintraoperativecomplicationsofvaginalsurgery

Effectivelyperformscomplexvaginalprocedures,withsupervisionManagescomplicationsofvaginalsurgery,withsupervisionCollaborateswithandprovidessubspecialty-specificconsultationtoothermembersofthehealthcareteam,withsupervision

IndependentlyandproficientlyperformscomplexvaginalproceduresAnticipates,diagnoses,andindependentlymanagesintra-operativecomplicationsrelatedtovaginalsurgeryIndependentlycollaborateswithandprovidessubspecialty-specificsurgicalconsultationtoothermembersofthehealthcareteamAppliesanevidence-basedapproachtoinnovativeandcomplextreatmentplansforbenigngynecologicconditionssurroundingvaginalsurgeryAbletoinstructresidentsinpropersurgicaltechniqueswithminimalguidance

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

Page 6: Minimally Invasive Gynecology Milestones These milestones ... · Level 2: The fellow is advancing and is performing at mid-fellowship level Level 3: The fellow has advanced and is

PC4:SurgicalcareofBenignGynecologicConditions:MinimallyInvasiveTechniques-HysteroscopyLevel1 Level2 Level3 Level4IndependentlyconsidershysteroscopicapproachwhenappropriateforbenigngynecologicconditionsUnderstandsstepsofhysteroscopicsurgeryandresectionandperformsstraightforwardproceduresindependentlyIdentifiescomplicationsofhysteroscopyandoutlinesmanagementstrategies

ProficientlyandsafelyperformsstraightforwardhysteroscopicresectionsRecognizesanddevelopsmanagementstrategiesforintraoperativecomplicationsofhysteroscopy

Effectivelyperformscomplexhysteroscopicprocedures,withsupervisionManagescomplicationsofhysteroscopy,withsupervisionCollaborateswithandprovidessubspecialty-specificconsultationtoothermembersofthehealthcareteam,withsupervision

IndependentlyandproficientlyperformscomplexhysteroscopicproceduresAnticipates,diagnoses,andindependentlymanagesintra-operativecomplicationsrelatedtohysteroscopyIndependentlycollaborateswithandprovidessubspecialty-specificsurgicalconsultationtoothermembersofthehealthcareteamAppliesanevidence-basedapproachtoinnovativeandcomplextreatmentplansforbenigngynecologicconditionssurroundinghysteroscopicsurgeryAbletoinstructresidentsinpropersurgicaltechniqueswithminimalguidance

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

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PC5:MedicalManagementofAbnormalUterineBleedingLevel1 Level2 Level3 Level4Demonstratesin-depthknowledgeofthephysiologyofthenormalmenstrualcycleDemonstratesabilitytoformulateadifferentialdiagnosisandperforminitialevaluationandtreatmentplanforpatientspresentingwithabnormaluterinebleedingDemonstratetheabilitytoutilizefocuseddiagnosticapproaches

Demonstratesanin-depthknowledgeregardingpatientspresentingwithtypicalabnormaluterinebleedingrelevanttovaryingpatternsofpresentation,comprehensivetreatmentoptions,andrefractorybleedingManagespatientswithcomplexandatypicalabnormaluterinebleedingwithacomprehensivemanagementplan,withsupervisionDemonstratestheabilitytoformulatecomprehensiveplansofmanagementforpatientswithmultipleand/orcomplexcomorbidities

IndependentlymanagespatientswithcomplexandatypicalabnormaluterinebleedingCollaboratesandprovidesconsultationtoothermembersofthehealthcareteamregardingabnormaluterinebleedingLeadsamultidisciplinaryteamforcareofpatientswithacuteandchronicabnormaluterinebleeding

Appliesinnovativeapproachestocomplexandatypicalabnormaluterinebleedingandimplementstreatmentplansbasedonemergingevidence

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

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PC6:PerioperativeCare,includingSurgeryonSpecialPopulationsLevel1 Level2 Level3 Level4AssessespreoperativesurgicalriskandproposesamanagementplantooptimizesurgicaloutcomesinbenigngynecologicpatientsAnticipates,diagnoses,andmanagesmedicaldisordersandsurgicalcomplicationsinbenigngynecologicpatientsduringthepostoperativeperiod

Identifiesspecialpatientpopulationswhichrequiresupplementalpreoperativeassessmentandindividualizedmanagementstrategies,accordingtotheirspecificpresentationordisease-state(i.e.obesity,BRCA+status,adolescents)RecognizesmedicaldisordersandsurgicalcomplicationsinpatientswithcomplexbenigngynecologicconditionsProposesmanagementstrategiesformedicaldisordersandsurgicalcomplicationsinpatientswithcomplexbenigngynecologicconditions

Implementsaplantooptimizesurgicaloutcomesinspecialpatientpopulationswithcomplexbenigngynecologicconditions,withsupervisionParticipatesincriticalcaremanagementofgynecologicsurgicalpatientswithcomplexmedicaldisorders,withsupervisionCollaborateswithandprovidessubspecialty-specificconsultationtoothermembersoftheperi-operativehealthcareteam,withsupervision

Independentlyassessespre-operativesurgicalriskanddevelopsaplantooptimizesurgicaloutcomeinspecialpatientpopulationswithcomplexbenigngynecologicconditionsIndependentlycollaborateswithandprovidessubspecialty-specificconsultationtoothermembersoftheperi-operativehealthcareteam,includingcriticalcarespecialistsAppliesanevidence-basedapproachtoinnovativeperi-operativemanagementofsurgicallycomplexpatients

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

Page 9: Minimally Invasive Gynecology Milestones These milestones ... · Level 2: The fellow is advancing and is performing at mid-fellowship level Level 3: The fellow has advanced and is

PC7:ManagementofLeiomyomataLevel1 Level2 Level3 Level4Demonstratetheabilitytoperforminitialevaluation,formulateafocuseddifferentialdiagnosis,andutilizefocuseddiagnosticapproachesforleiomyomataFormulateacomprehensivemanagementplan,withassistance

Demonstrateanin-depthknowledgeregardingevaluation,workup,andcounselingofpatientswithleiomyomataDemonstratestheabilitytoformulatecomprehensivemanagementplansforpatientsbasedonage,anatomiclocation,symptoms,andreproductivedesires

CollaboratesandprovidesconsultationtoothermembersofthehealthcareteamregardingleiomyomataIndependentlyimplementscomprehensivemanagementplansforpatientswithleiomyomata,includingsurgicalandmedicalmanagementoptions

IndependentlyandproficientlyperformscomplexproceduresonleiomyomataAnticipates,diagnoses,andindependentlymanagesintra-operativeanatomicchallengesandcomplicationsrelatedtoleiomyomataIndependentlycollaborateswithandprovidessubspecialty-specificsurgicalconsultationtoothermembersofthehealthcareteamAppliesinnovativeapproachestoleiomyomataandimplementstreatmentplansbasedonemergingevidence

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

Page 10: Minimally Invasive Gynecology Milestones These milestones ... · Level 2: The fellow is advancing and is performing at mid-fellowship level Level 3: The fellow has advanced and is

PC8:ManagementofEndometriosisLevel1 Level2 Level3 Level4Demonstratetheabilitytoperforminitialevaluation,formulateafocuseddifferentialdiagnosis,andutilizefocuseddiagnosticapproachesforendometriosisFormulateacomprehensivemanagementplan,withassistance

Demonstrateanin-depthknowledgeregardingevaluation,workup,andcounselingofpatientswithendometriosisDemonstratestheabilitytoformulatecomprehensivemanagementplansforpatientsbasedonage,anatomiclocation,symptoms,andreproductivedesires

CollaboratesandprovidesconsultationtoothermembersofthehealthcareteamregardingendometriosisIndependentlyimplementscomprehensivemanagementplansforpatientswithendometriosis,includingsurgicalandmedicalmanagementoptionsConsultsotherservicesappropriatelyforendometriosisrelatedsurgicalissues

IndependentlyandproficientlyperformscomplexproceduresforendometriosisAnticipates,diagnoses,andindependentlymanagesintra-operativeanatomicchallengesandcomplicationsrelatedtoendometriosisIndependentlycollaborateswithandprovidessubspecialty-specificsurgicalconsultationtoothermembersofthehealthcareteamAppliesinnovativeapproachestoleiomyomataandimplementstreatmentplansbasedonemergingevidence

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

Page 11: Minimally Invasive Gynecology Milestones These milestones ... · Level 2: The fellow is advancing and is performing at mid-fellowship level Level 3: The fellow has advanced and is

PC9:ManagementofAdnexalPathology/PelvicMassLevel1 Level2 Level3 Level4Demonstratetheabilitytoperforminitialevaluation,formulateafocuseddifferentialdiagnosis,andutilizefocuseddiagnosticapproachesforpelvicmassFormulateacomprehensivemanagementplan,withassistance

Demonstrateanin-depthknowledgeregardingevaluation,workup,andcounselingofpatientspresentingwithapelvicmassrelevanttovaryingpatternsofpresentationandcomprehensivetreatmentoptionsDemonstratetheabilitytoformulatecomprehensivemanagementplansforpatientsbasedonage,anatomiclocation,symptoms,andreproductivedesiresDeterminetheneedforconsultation,referral,ortransferofpatientsDemonstratestheabilitytoformulatecomprehensivemanagementplansforpatientswithmultipleand/orcomplexcomorbidities

CollaboratesandprovidesconsultationtoothermembersofthehealthcareteamregardingpelvicmassIndependentlyimplementscomprehensivemanagementplansforpatientswithadnexalpathology,includingsurgicalandmedicalmanagementoptionsConsultsotherservicesappropriatelyforsurgicalissuesrelatedtoadnexalpathology

Appliesinnovativeapproachestocomplexandatypicalpelvicmassandimplementstreatmentplansbasedonemergingevidence

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

Page 12: Minimally Invasive Gynecology Milestones These milestones ... · Level 2: The fellow is advancing and is performing at mid-fellowship level Level 3: The fellow has advanced and is

PC10:ManagementofPelvicPainLevel1 Level2 Level3 Level4DemonstratesabilitytoformulateadifferentialdiagnosisandperforminitialevaluationandtreatmentplanforpatientspresentingwithacuteorchronicpelvicpainDemonstratetheabilitytoutilizefocuseddiagnosticapproaches

Demonstrateanin-depthknowledgeregardingpatientspresentingwithacuteorchronicpelvicpainrelevanttovaryingpatternsofpresentation,treatmentoptions,andrefractorypelvicpainManagespatientswithcomplexandatypicalacuteandchronicpelvicpainwithacomprehensivemanagementplan,withsupervisionDemonstratestheabilitytoformulatecomprehensiveplansofmanagementforpatientswithmultipleand/orcomplexcomorbidities

IndependentlymanagespatientswithcomplexandatypicalacuteandchronicpelvicpainLeadsamultidisciplinaryteamforcareofpatientswithacuteorchronicpelvicpain

Appliesinnovativeapproachestocomplexandatypicalacuteandchronicpelvicpainandimplementstreatmentplansbasedonemergingevidence

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

Page 13: Minimally Invasive Gynecology Milestones These milestones ... · Level 2: The fellow is advancing and is performing at mid-fellowship level Level 3: The fellow has advanced and is

MK1(Anatomy)Level1 Level2 Level3 Level4Demonstratesknowledgeofbasicpelvicanatomytoincludemajororgansincludingneurovascularandmusculoskeletalstructures

Demonstratesknowledgeofthevascularandnervesupplytoeachofthepelvicorgansandstructures,includingtheexternalgenitalia,uterus,adnexa,ureter,bladder,andrecto-sigmoidcolonDemonstratesknowledgeofnormalretroperitonealanatomy

AppliesknowledgeofnormalpelvicandabdominalanatomyinthesurgicalsettingDemonstratesknowledgeofpelvic,retroperitoneal,andupperabdominalanatomydistortedbybenigngynecologicconditions(i.e.endometriosis,fibroids,adnexalmass,adhesions,mülleriananomalies)

Appliesknowledgeofpelvic,retroperitoneal,andupperabdominalanatomydistortedbybenigngynecologicconditionsinacomplexsurgicalsettingAppliesknowledgeofanatomywhenreviewingdiagnosticstudies

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

Page 14: Minimally Invasive Gynecology Milestones These milestones ... · Level 2: The fellow is advancing and is performing at mid-fellowship level Level 3: The fellow has advanced and is

MK2:MenstrualCyclePhysiologyandManagementofHormonalInterventionLevel1 Level2 Level3 Level4Understandsbasicreproductivephysiologyanddescribeshormonalchangesundernormalphysiologicconditions

EffectivelyassistsindiagnosingirregularitiesinmenstrualfunctionRecognizesanddevelopsmanagementstrategyforirregularitiesrelatedtomenstrualdysfunction,includingabnormaluterinebleeding,post-menopausalhormonaltherapy,andendometriosis

EffectivelydevelopstreatmentplansforirregularitiesrelatedtomenstrualdysfunctionManagesirregularitiesrelatedtomenstrualdysfunction,includingabnormaluterinebleeding,post-menopausalhormonaltherapy,andendometriosis,withsupervisionCollaborateswithandprovidessubspecialty-specificconsultationtoothermembersofthehealthcareteam,whenappropriate

IndependentlyandproficientlyperformsmedicaldecisionmakingrelatedtomenstrualdysfunctionAnticipates,diagnoses,andindependentlymanagescomplexmedicalsituationsrelatedtomenstrualdysfunction,includingabnormaluterinebleeding,hormonaltherapy,andendometriosis,whennotrespondingtofirst-lineinterventionIndependentlycollaborateswithandprovidessubspecialty-specificconsultationtoothermembersofthehealthcareteam

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

Page 15: Minimally Invasive Gynecology Milestones These milestones ... · Level 2: The fellow is advancing and is performing at mid-fellowship level Level 3: The fellow has advanced and is

MK3:DiagnosticTechniquesandTreatmentPlanningLevel1 Level2 Level3 Level4Demonstratesknowledgeofbasicimagingmodalitiesusedtoevaluatepatientswithbenigngynecologicconditions(e.g.ultrasound,HSG,MRI)Demonstratesknowledgeofbasicdiagnostictechniquesusedtoevaluatepatientswithbenigngynecologicconditions(e.g.endometrialbiopsy,colposcopy)

Appliesknowledgeofimagingmodalitiesanddiagnostictechniquestoplanappropriatesurgicalormedicalinterventionforbenigngynecologicconditions

Collaborateswithradiologistorotherspecialiststodeterminewhichimagingmodalitiesordiagnostictechniqueswouldbemosthelpfulindiagnosisandmanagementplan

Appliesknowledgeofdiagnostictechniquestoformulatetreatmentplansinthemostcomplexsettingandadjuststreatmentplansaccordinglyforpatientswithabnormalresults

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

Page 16: Minimally Invasive Gynecology Milestones These milestones ... · Level 2: The fellow is advancing and is performing at mid-fellowship level Level 3: The fellow has advanced and is

MK4:CongenitalAnomaliesLevel1 Level2 Level3 Level4Demonstratesknowledgeofbasicimagingmodalitiesusedtoevaluatepatientswithcongenitalanomalies(e.g.ultrasound,HSG,MRI)Demonstratesknowledgeofbasicdiagnostictechniquesusedtoevaluatepatientswithcongenitalanomalies

Appliesknowledgeofimagingmodalitiesanddiagnostictechniquestoplanappropriatesurgicalormedicalinterventionforcongenitalanomalies

Collaborateswithradiologistorotherspecialiststodeterminewhichimagingmodalitiesordiagnostictechniqueswouldbemosthelpfulindiagnosisandmanagementplan

Appliesknowledgeofpelvic,retroperitoneal,andupperabdominalanatomyinspecificcongenitalanomaliestoformulatecomprehensivepatientspecifictreatmentplansImplementsknowledgeofcongenitalanomalies,resultsofevaluation,andpatientfactorstoformulatecomplexcomprehensivetreatmentplansforpatientswithcongenitalanomaliesandutilizesthisinformationinmodifyingthesurgicalapproach

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

Page 17: Minimally Invasive Gynecology Milestones These milestones ... · Level 2: The fellow is advancing and is performing at mid-fellowship level Level 3: The fellow has advanced and is

MK5:PelvicFloorDisordersLevel1 Level2 Level3 Level4Demonstratesthemedicalknowledgesurroundingpelvicfloordisordersinthediagnosis,evaluation,andcounselingofthesepatientsPerformssystematicevaluationofthepelvicfloorandordersappropriatetestingwithsupervisionFormulateacomprehensivemanagementplan,withassistance

AppliesknowledgeofpelvicfloordisorderstocounselpatientsregardingmedicalandsurgicaloptionsfortherapyFormulatesacomprehensivetreatmentplanforpatientswithpelvicfloordisorders

Collaborateswithotherspecialiststodeterminewhichtherapeuticmodalitiesordiagnostictechniqueswouldbemosthelpfulindiagnosisandmanagementplansofpatientswithcomplexpelvicfloordisorders

Appliesknowledgeofpelvicfloordisordersinacomplexsetting

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

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SBP1:ComputerSystemsLevel1 Level2 Level3 Level4Retrievesbasicpatientinformationfromtheelectronicmedicalrecord(EMR)

RetrievescomplexpatientinformationfromtheEMR

Generatesorders,communicateswithreferringphysiciansandtrainees,anddocumentscommunicationwithpatients

UsesEMRtoitsfullpotential,andfacilitatesintegrationofcomputer-basedcommunicationwithteam

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐ SBP2:Value-basedPatientCare(Quality/Cost)Level1 Level2 Level3 Level4Demonstratesknowledgeofgeneralobstetricsandgynecologyguideline-basedcare(e.g.,AmericanCollegeofObstetriciansandGynecologists[ACOG]publications)Demonstratesknowledgeoftheimportanceofprovidingcost-effectivecareUnderstandsthediversityandrolesofallmembersofthehealthcareteam

Demonstratesknowledgeofguideline-basedcarespecifictominimallyinvasivegynecologyDemonstratesknowledgeofcostrelatedtodiagnosticandtreatmentplansDemonstratesknowledgeofpersonnelandresourcesneededtofacilitatevalue-based(highquality,cost-effective)care

Appliesknowledgeofguideline-basedcarespecifictominimallyinvasivegynecology,withsupervisionIncorporatescost-awarenessintothedevelopmentofdiagnosticandtreatmentplans,withsupervision(e.g.,formularydrugs,genericdrugs,tailoringofdiagnostictests)Coordinatespersonnelandresourcestofacilitatevalue-basedcare,withsupervision

Independentlyappliesknowledgeofguideline-basedcarespecifictominimallyinvasivegynecologyIndependentlyincorporatescost-awarenessintothedevelopmentofdiagnosticandtreatmentplansIndependentlycoordinatespersonnelandresourcestofacilitatevalue-basedcare

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

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PBLI1:ScholarlyactivityLevel1 Level2 Level3 Level4Criticallyreviewsandinterpretspublicationswiththeabilitytoidentifyhypotheses,studyaims,design,results,andlimitationsDemonstratesknowledgeofcommonlyusedstudydesigns(e.g.,randomizedcontrolledtrial[RCT],cohort,case-control)Demonstratesknowledgeofbasicprinciplesunderlyingtheethicalconductofresearchandtheprotectionofhumansubjects

Designsahypothesis-drivenorhypothesis-generatingscholarlythesis,underthedirectionofaresearchmentorDemonstratesknowledgeofadvancedstudydesignsandstatisticalmethodologyAppliestheprinciplesofethicsandgoodclinicalpracticetotheprotectionofhumansubjectsrecruitedtoparticipateinresearch,asindicated

Executesahypothesis-drivenorhypothesis-generatingscholarlythesis,underthedirectionofaresearchmentorAppliesknowledgeofadvancedstudydesignandstatisticalmethodologytoresearch,includingascholarlythesisComplieswithresearchoversightregulations

Completesanddefendsacomprehensivewrittenscholarlythesisthatdemonstrates:-advancedresearchmethodologyanddesign-statisticalanalysis-synthesisofscientificliterature,hypothesistesting,anddescriptionsoffindingsandresults

Comments:Notyetachievedlevel1:☐ PBLI2:Qualityimprovement(QI)Level1 Level2 Level3 Level4Identifiesproblemsinhealthcaredelivery

BeginsworkingonaQIproject,eitherasanindividualorasateammember

ContinuestodevelopaQIproject,employingmethodstomeasureandanalyzethedata

CompletesaQIproject,eitherasanindividualorteammemberDisplayseffectiveteamworkskills

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

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PROF1:ProfessionalethicsandaccountabilityLevel1 Level2 Level3 Level4Demonstratesintegrity,respect,honesty,andcompassionIshonestandtruthfulinallcircumstancesUnderstandsHIPAApoliciesandappropriateuseconceptsDemonstratestimelinessincompletionofassignedrotations,reports,statelicensure,andduties

Isaccountableincompletionofduties,records,andpatientcareIssensitiveandresponsivetodiversepatientpopulationandneeds,regardlessofgender,age,race,sexualorientation,religion,ordisabilitiesDemonstratesknowledgeofregulationsforbillingandcoding

Acknowledgeserrorswithprogramdirector,facultymembers,and/orpatientsRespondswelltoconstructivecriticismTakesonresponsibilityrelatedtolearning,coordinationofcare,patientcare,ContinuousQualityImprovement(CQI),andcomplianceissues

Servesasarolemodelforhonesty,integrity,professionalism,andcompassionatepatientcareDemonstratescommitmenttoself-improvementPrioritizesandadvocatesforpatientneedsoverself-interestOperatesprofessionallyandindependentlyinvariouseducationalandpatientcareenvironments

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

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PROF2:Compassion,Integrity,andRespectforOthersLevel1 Level2 Level3 Level4Understandstheimportanceofcompassion,integrity,andrespectforothersDemonstratessensitivityandresponsivenesstopatients

Consistentlyshowscompassion,integrity,andrespectintypicalsituationswithpatients,peers,andmembersofthehealthcareteamConsistentlydemonstratessensitivityandresponsivenesstodiversityofpatients’ages,cultures,races,religions,abilities,orsexualorientationsAcceptsconstructivefeedbacktoimprovehisorherabilitytodemonstratecompassion,integrity,andrespectforothers

Consistentlyshowscompassion,integrity,andrespectforpatientswhodeclinemedicaladvice,requestun-indicatedtestsortreatments,orhavepsychiatriccomorbidities,andforteammembersexperiencingconflictorhighstressModifieshisorherownbehaviorbasedonfeedbacktoimprovehisorherabilitytodemonstratecompassion,integrity,andrespectforothers

Consistentlymodelscompassion,integrity,andrespectforothersCoachesotherstoimprovecompassion,integrity,andrespectforpatients

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

Page 22: Minimally Invasive Gynecology Milestones These milestones ... · Level 2: The fellow is advancing and is performing at mid-fellowship level Level 3: The fellow has advanced and is

ICS1:TeamworkandCommunicationwithPhysiciansandOtherHealthProfessionalsLevel1 Level2 Level3 Level4Understandstheimportanceofrelationshipdevelopment,informationgatheringandsharing,andteamwork

Demonstratesanunderstandingoftherolesofhealthcareteammembers,andcommunicateseffectivelywithintheteamDemonstratesanunderstandingoftransitionsofcareandteamdebriefing

WorkseffectivelyininterprofessionalandinterdisciplinaryhealthcareteamsParticipatesineffectivetransitionsofcareandteamdebriefingCommunicateseffectivelywithphysiciansandotherhealthcareprofessionalsregardingpatientcare

LeadsinterprofessionalandinterdisciplinaryhealthcareteamstoachieveoptimaloutcomesLeadseffectivetransitionsofcareandteamdebriefingRespondstorequestsforconsultationinatimelymanner,andcommunicatesrecommendationstotherequestingteam

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐

Page 23: Minimally Invasive Gynecology Milestones These milestones ... · Level 2: The fellow is advancing and is performing at mid-fellowship level Level 3: The fellow has advanced and is

ICS2:CommunicationwithPatientsandFamiliesLevel1 Level2 Level3 Level4DemonstratesadequatelisteningskillsCommunicateseffectivelyinroutineclinicalsituations

ChecksforpatientandfamilyunderstandingofillnessandmanagementplanAllowsforopportunitiesforpatientquestionsMaintainscommunicationwithpatientandfamilyregardingplanofcare

Communicateseffectivelywithpatientsandfamiliesacrossabroadrangeofsocio-economicandculturalbackgroundsCommunicateseffectivelyinstressful,emergent,andcomplexsituations(e.g.,complications,poorprognosis,patientdeath)

RolemodelseffectivecommunicationCapableofinformingpatientsandfamiliesaboutamedicalerrorthatcausedharm

☐ ☐ ☐ ☐ ☐ ☐ ☐ Comments:Notyetachievedlevel1:☐