17 Oct Assessing Internal Medicine Resident Performance: Feedback on Reporting Milestones
MedicalResearch.com Interview with:
Eva Aagaard, MD
Associate Professor of Medicine, Assistant Dean for Lifelong Learning, Director of the Academy of Medical Educators, Director of the Center for Advancing Professional Excellence, and Director of Faculty Development in General Internal Medicine at the University of Colorado
MedicalResearch.com: What are the main findings of the study?
Dr. Aagaard: We obtained feedback on, and assessed the construct validity and perceived feasibility and utility of, draft Internal Medicine Milestones for Patient Care and Systems-Based Practice used a mixed methods study involving competency committee members in Internal Medicine residency programs. An initial survey assessed participant and program demographics; focus groups obtained feedback on the draft milestones and explored their perceived utility in resident assessment, and an exit survey elicited input on the value of the draft milestones in resident assessment. Thirty-four participants from 17 programs completed surveys and participated in 1 of 6 focus groups. Overall, the milestones were perceived as useful in formative and summative assessment of residents. Participants raised concerns about the length and complexity of some draft milestones and suggested specific changes. The focus groups also identified a need for faculty development. In the exit survey, most participants agreed that the Patient Care and Systems-Based Practice Milestones would help competency committees assess trainee progress toward independent practice.
MedicalResearch.com: Were any of the findings unexpected?
Dr. Aagaard: This has been a tough transition toward competency-based education for almost all IM residency programs. I was gratified to see such strong belief that these milestones would be considered a useful aid.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Aagaard: The reporting milestones in Internal Medicine are an important step forward in competency—based residency education. However, as with all new tools, their successful implementation will require significant faculty development both of program directors and faculty. Moreover, they will need refinement after widespread review.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Aagaard: Additional research is necessary to validate the milestones; more importantly, assessment tools that are developed as a result of these milestones will require further evaluation to assess reliability and validity. Finally, future research should assess whether these new frameworks actually improve assessment of competence and ultimately patient care.
Eva Aagaard, Gregory C. Kane, Lisa Conforti, Sarah Hood, Kelly J. Caverzagie, Cynthia Smith, Davoren A. Chick, Eric S. Holmboe, and William F. Iobst (2013) Early Feedback on the Use of the Internal Medicine Reporting Milestones in Assessment of Resident Performance. Journal of Graduate Medical Education: September 2013, Vol. 5, No. 3, pp. 433-438.