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Pediatric Program Director Minimum Milestone Expectations Before Allowing Supervision of Others and Unsupervised
Su-Ting T Li1, Daniel J Tancredi2, Alan Schwartz3
1Department of Pediatrics, University of California Davis, Sacramento, Calif.
Academic Pediatrics
|April 29, 2018
Summary
Most pediatric residency programs lack defined minimum Milestones for resident supervision and graduation. Program directors prioritize humanism and professionalization for supervision readiness and help-seeking for graduation readiness.
Area of Science:
- Graduate Medical Education
- Medical Education Research
- Pediatric Residency Training
Background:
- The Accreditation Council for Graduate Medical Education mandates semiannual Milestone reporting for all residents.
- Current Milestone performance expectations are not clearly defined or universally understood.
Purpose of the Study:
- To ascertain pediatric program directors' minimum Milestone expectations for residents.
- To identify expectations before residents are ready for independent supervision and before graduation.
Main Methods:
- A mixed-methods survey was administered to pediatric program directors.
- Data collected included established Milestone expectations and how Milestones inform supervision and graduation decisions.
- Quantitative analysis of mean minimum Milestone levels and thematic analysis of free-text responses were performed.
Main Results:
- A high percentage of programs (80-84%) have no required minimum Milestone levels.
- For readiness to supervise, highest considered expectations were for humanism and professionalization.
- For readiness to graduate, highest considered expectations were for help-seeking.
- Milestones are used with other data, and not equally weighted in advancement decisions.
Conclusions:
- The majority of program directors have not set program-specific minimum Milestones.
- Milestone expectations are considered variable based on specific competencies.
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