A National Study of Longitudinal Consistency in ACGME Milestone Ratings by Clinical Competency Committees
| Autor: | Michael S. Beeson, Sally A. Santen, Melissa A. Barton, Stanley J. Hamstra, Eric S. Holmboe, Kenji Yamazaki |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Educational measurement 020205 medical informatics Urology Graduate medical education MEDLINE 02 engineering and technology Education 03 medical and health sciences 0302 clinical medicine 0202 electrical engineering electronic engineering information engineering medicine Milestone (project management) Humans Longitudinal Studies 030212 general & internal medicine Competence (human resources) Accreditation Multilevel model Internship and Residency Reproducibility of Results Research Reports General Medicine Education Medical Graduate Family medicine ComputingMethodologies_DOCUMENTANDTEXTPROCESSING Emergency Medicine Multilevel Analysis National study Clinical Competence Educational Measurement Radiology Psychology |
| Zdroj: | Academic Medicine |
| ISSN: | 1040-2446 |
| DOI: | 10.1097/acm.0000000000002820 |
| Popis: | Supplemental Digital Content is available in the text. Purpose To investigate whether clinical competency committees (CCCs) were consistent in applying milestone ratings for first-year residents over time or whether ratings increased or decreased. Method Beginning in December 2013, the Accreditation Council for Graduate Medical Education (ACGME) initiated a phased-in requirement for reporting milestones; emergency medicine (EM), diagnostic radiology (DR), and urology (UR) were among the earliest reporting specialties. The authors analyzed CCC milestone ratings of first-year residents from 2013 to 2016 from all ACGME-accredited EM, DR, and UR programs for which they had data. The number of first-year residents in these programs ranged from 2,838 to 2,928 over this time period. The program-level average milestone rating for each subcompetency was regressed onto the time of observation using a random coefficient multilevel regression model. Results National average program-level milestone ratings of first-year residents decreased significantly over the observed time period for 32 of the 56 subcompetencies examined. None of the other subcompetencies showed a significant change. National average in-training examination scores for each of the specialties remained essentially unchanged over the time period, suggesting that differences between the cohorts were not likely an explanatory factor. Conclusions The findings indicate that CCCs tend to become more stringent or maintain consistency in their ratings of beginning residents over time. One explanation for these results is that CCCs may become increasingly comfortable in assigning lower ratings when appropriate. This finding is consistent with an increase in confidence with the milestone rating process and the quality of feedback it provides. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|