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Related Experiment Video

Updated: Jan 23, 2026

Measuring Cardiac Autonomic Nervous System ANS Activity in Toddlers - Resting and Developmental Challenges
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Challenges in measuring ACGME competencies: considerations for milestones.

Prathiba Natesan1, Nicholas J Batley2, Rinad Bakhti3

  • 1Department of Educational Psychology, University of North Texas, 1155 Union Circle #311335, Denton, TX, 76203, USA.

International Journal of Emergency Medicine
|June 11, 2019
PubMed
Summary

Accreditation Council for Graduate Medical Education (ACGME) competency evaluations show severe multicollinearity, indicating poor validity. Current tools may not accurately assess resident performance, suggesting a need for improved evaluation strategies.

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Area of Science:

  • Medical Education Research
  • Graduate Medical Training Assessment
  • Competency-Based Education

Background:

  • Ensuring resident competency is crucial for Accreditation Council for Graduate Medical Education (ACGME) standards.
  • Previous research indicates physicians often use global ratings, relying on single criteria for evaluations.
  • This study examines the validity of ACGME International competency measures in an international context.

Purpose of the Study:

  • To validate Accreditation Council for Graduate Medical Education (ACGME) International competency measures in emergency medicine (EM) and neurology.
  • To analyze the performance of these measures across different evaluators and specialties.
  • To identify potential issues with current competency assessment tools used in resident training.

Main Methods:

  • Advanced statistical analysis, including Confirmatory Factor Analysis (CFA), was applied to EM and neurology data.
  • CFA models were tested and modified based on fit indices to assess construct validity.
  • Measurement invariance tests were conducted to examine differences in competency perception among EM physicians.

Main Results:

  • High reliability coefficients and factor loadings (>.93) indicated significant multicollinearity among evaluated items.
  • This multicollinearity suggests that most items were redundant and measured the same underlying construct.
  • The findings were consistent across both EM and neurology datasets and all six EM faculty evaluators.

Conclusions:

  • Evaluation forms for the six core ACGME competencies lack adequate validity due to severe multicollinearity.
  • The upcoming ACGME milestones with numerous sub-competencies may exacerbate existing assessment flaws if tool weaknesses are ignored.
  • A more effective evaluation process should acknowledge and incorporate physician subjectivity for more meaningful feedback.