WHAT’S THE SCOOPON

TY MILESTONES?

Steve Craig, MD & Danny Takanishi, MDand Members of the TY Milestones Working Group

Organization of Today’s Panel Presentation

Background: ACGME Outcome Project: Milestone Development Phase

Use of Milestones in the ACGME’s Next Accreditation System

TY Milestones Development Process Summary of TY Milestones Working Group

Progress Review of TY Medical Knowledge Milestone Next Steps in TY Milestones Development Questions for Panel

The ACGME Outcome Project

Susan Swing, PhD ~ ACGME Annual Educational Conference ~ March 2, 2012

Susan Swing, PhD ~ ACGME Annual Educational Conference ~ March 2, 2012

Susan Swing, PhD ~ ACGME Annual Educational Conference ~ March 2, 2012

Susan Swing, PhD ~ ACGME Annual Educational Conference ~ March 2, 2012

Susan Swing, PhD ~ ACGME Annual Educational Conference ~ March 2, 2012

Susan Swing, PhD ~ ACGME Annual Educational Conference ~ March 2, 2012

Susan Swing, PhD ~ ACGME Annual Educational Conference ~ March 2, 2012

Susan Swing, PhD ~ ACGME Annual Educational Conference ~ March 2, 2012

Susan Swing, PhD ~ ACGME Annual Educational Conference ~ March 2, 2012

Susan Swing, PhD ~ ACGME Annual Educational Conference ~ March 2, 2012

TY Milestones Development

Late 2010: ACGME asked Steve Craig (CTYPD) + Danny Takanishi (TYRC) to co-chair Working Group

Early 2011 call for interested TYPDs to apply

Co-Chairs & ACGME staff selected core working group (other applicants to serve as advisory group)

Arranged first TY Milestones Working Group Meeting in Chicago May 3-4, 2011

TY Milestones Working Group

Co-Chairs: Steve Craig & Danny Takanishi

CTYPD Members: Matt Short, Cathy Nace, Marko Jachtorowycz

At-Large Members: Nikhil Goyal, Ernest Moritz, Ethan Natelson, Mukta Panda

Additional TYRC Member: Robert Bing-You

Resident Member: Karolyn Wanat Staff Support: Steve Nestler, Linda

Thorsen

First Working Group Meeting

Overview of ACGME Milestones Project provided

Discussed Goals + Desired Work Product Reviewed Organizational Framework Reviewed Milestones Work from Other

Specialties(especially IM, Pediatrics, General Surgery)

Began Milestone Development for Patient Care & Medical Knowledge competencies

Milestones Developmental Decisions

Competence observed in performance

→ Articulate milestones in behavioral language

Multiple evaluation approaches needed

→ Link milestones to general evaluation strategies

“Competence” is tricky along the education continuum

→ Expectation at end of PGY-1 Year: safe to enter independent practice?

TY Milestones: Unique Challenges

We are the only one-year residency training program

We do not typically produce graduates ready for unsupervised practice

Need TY milestones to be equivalent to preliminary year training milestones (e.g. Medicine + Surgery)

Need TY milestones to be accepted by categorical specialty programs that our graduates enter

Need milestones to be achievable and measurable in shortened one year training period

TY Milestones Timeline

Three Meetings to Date May 3-4, 2011: Orientation, Organization,

Review of other specialty’s milestones, Work on Patient Care (PC) + Medical Knowledge (MK) milestones

October 13-14, 2011: Worked on milestones for other 4 competencies (reviewed Expert Panel’s work) + refined PC & MK Milestones

March 1, 2012: Refined milestones for all 6 competencies: PC, MK, ICS, PBLI, Prof, SBP

March/April 2012: Assessment instruments for milestones considered

WHAT Do We Have Here? Milestones for all 6 competencies Possible assessment tools that can be used

for each milestone Tomorrow morning’s workshop will review

current draft of all the milestones + recommended assessment tools

Split into 5 groups: Share input with Working Group members who will lead each group

Milestones Completed for All 6 Competencies

Will briefly review Medical Knowledge milestone today

Discuss format used for milestones + how assessment tools identified

Tomorrow morning’s workshop: Split into 5 groups to review other milestones

Working Group Members will lead each of 5 groups

Seek input, comments, suggestions about individual milestones and recommended assessment tools

Review of Milestones Development

Milestone Construct: Articulate in behavioral language

Key assessment points Beginning of Training (Novice) After 6 Months of Training (Advanced

Beginner) End of TY Training (Competent) End of Categorical Training (Proficient) Practicing Physician (Expert)

Assessment Methods / Tools (See Handout)

MK Milestone #1

MK Milestone #1 Assessment Tools

MK Milestone #2

MK Milestone #2 Assessment Tools

WHERE Do We Go From Here?

Synthesize feedback on milestones draft from this workshop + from recent TYRC review

Advisory Group to review milestones draft Arrange for Categorical Residency Program

Reps to review milestones draft TY Milestones Working Group will meet to

finalize milestones based on this input Work with ACGME staff and TY RRC to

finalize milestone reporting mechanism for TY programs

How Can You Prepare for Milestones?

Faculty development to increase understanding of the 6 competency domains

Introduce principles of CBME: culture shift to criterion-referenced assessment

Begin structuring competency committee(s) Composition? How many? Determine how to assess resident milestone

performance Determine how to compile/synthesize assessments

When milestones are available Begin to align assessment tools Discuss expected performance at different levels

QUESTIONS?

&DISCUSSION

TOMORROW MORNINGGRAND SALON B-C

0700: Bootcamp for New Program Directors

0800: TY Milestones Workshop Bring your assessment tools handout!

0900: TY Best Practices