Document Type
Article
Publication Title
Academic Medicine - Journal of the Association of American Medical Colleges
Abstract
Purpose
To describe clinical skills progression during pediatric residency using the distribution of pediatric milestone assessments by subcompetency and year of training and to determine reasonable milestone expectations at time of graduation.
Method
Multi-institutional cohort study of the milestones reported to the Accreditation Council for Graduate Medical Education for all 21 pediatric subcompetencies. Most subcompetencies were measured using five milestone levels (1 = novice, 2 = advanced beginner, 3 = competent, 4 = proficient, 5 = master); 3 subcompetencies had only four levels defined.
Results
Milestone assessments for 2,030 pediatric residents in 47 programs during academic year 2013–2014 were obtained. There was significant variation in end-of-year milestone ratings for residents within each level of training, which decreased as training level increased. Most (78.9%; 434/550) graduating third-year pediatric residents received a milestone rating of ≥ 3 in all 21 subcompetencies; fewer (21.1%; 116/550) received a rating of ≥ 4 in all subcompetencies. Across all training levels, professionalism and interpersonal communication skills were rated highest; quality improvement was rated lowest.
Conclusions
Trainees entered residency with a wide range of skills. As they advanced, skill variability within a training level decreased. Most graduating pediatric residents were still advancing on the milestone continuum toward proficiency and mastery, and an expectation of milestone ratings ≥ 4 in all categories upon graduation is unrealistic; milestone ratings ≥ 3 upon graduation may be more realistic. Understanding current pediatric residents’ and graduates’ skills can help to identify key areas that should be specifically targeted during training.
First Page
385
Last Page
393
DOI
10.1097/ACM.0000000000001322
Publication Date
3-2017
Department
College of Medicine
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Li, Su-Ting T. MD, MPH; Tancredi, Daniel J. PhD; Schwartz, Alan PhD; Guillot, Ann P. MD; Burke, Ann E. MD; Trimm, R. Franklin MD; Guralnick, Susan MD; Mahan, John D. MD; Gifford, Kimberly A. MD. Competent for Unsupervised Practice: Use of Pediatric Residency Training Milestones to Assess Readiness. Academic Medicine 92(3):p 385-393, March 2017. | DOI: 10.1097/ACM.0000000000001322
Comments
Use the publisher's citation (see recommended citation below) when citing this article.