Regions Emergency Medicine Residency
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Transcript Regions Emergency Medicine Residency
Implementing Milestones:
Historical context, competency based medical
education, and outcomes
CORD Academic Assembly
April 2, 2012
Felix Ankel
Michael Beeson
Patrick Brunett
http://www.youtube.com/watch?v=Q
y1dpLmJTrY&feature=related
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www.wordle.net
Worldle map
Dreyfus model of skill acquisition
Six Aptitudes
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Milestones
Observable, measurable behaviors
Acknowledges developmental stages
Linked to level of training
Expected time frame for achievement
Milestones
Narrative anchors
Based on knowledge, skills and
attitudes
– KSAs
Balance between
– Deconstruction (microtasks)
– Integration (complex performance)
Milestones
5 levels of proficiency
– Novice (entry level med school graduate)
– Beginner
– Competent
– Proficient (graduating resident)
– Expert (advanced practitioner)
Assessment under
New Accreditation System
Continuous process
OK for trainees to meet expectations
ahead of schedule
Failure to meet milestones may trigger
further assessment, intervention,
remediation
Assessment under
New Accreditation System
Integrated set of complex performance
expectations
Personal and professional development
Done with (not to) residents
Reported every 6 months
Assessment of program effectiveness
Assessment under
New Accreditation System
Integrated set of complex performance
expectations
Personal and professional development
Done with (not to) residents
Assessment of program effectiveness
Example from Internal Medicine
EM Milestones
Aligned with core competencies
Specialty-specific vs. universal skills
Parallels development of ABEM Initial
Certification criteria
Linked to “Physician Tasks” (Model of
Clinical Practice of EM)
EM Milestones under
New Accreditation System
Roll out of pilot in 2013
One of 7 “early adopter” specialties
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emergency medicine
internal medicine
neurosurgery
orthopedics
pediatrics
radiology
urology