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Creating a New Set of Milestones for the Clinical Neurophysiology Fellowship
Dara V F Albert1, Brian J Hanrahan2, Marcia V Felker3
1Division of Child Neurology, Department of Pediatrics, Nationwide Children's Hospital/The Ohio State University, Columbus, Ohio, U.S.A.
Summary
The clinical neurophysiology (CNP) fellowship milestones were updated to enhance fellow evaluation. Key revisions include new Patient Care milestones for telemedicine and intraoperative monitoring, with a focus on program-specific goals.
Area of Science:
- Neurology
- Medical Education
Background:
- The Accreditation Council for Graduate Medical Education and the American Board of Psychiatry and Neurology established initial milestones for clinical neurophysiology (CNP) fellowships in 2015.
- These milestones assess fellow development across six core competency domains.
Purpose of the Study:
- To describe the development and key features of a revised set of milestones for CNP fellowship training.
- To establish a tiered evaluation system with Level 1 as entry, Level 4 as graduation goal, and Level 5 as aspirational.
Main Methods:
- Committee members were nominated or volunteered for the update process.
- Milestone development involved creating a shared mental model of essential skills and knowledge for graduating fellows.
- The committee convened virtually for seven meetings, totaling 14 hours.
Main Results:
- The revised milestones expanded to nine Patient Care and five Medical Knowledge milestones, up from seven and six respectively.
- Eleven "Harmonized Milestones" were integrated into the updated framework.
- A supplemental guide was created to support the implementation of the revised milestones.
Conclusions:
- Program directors should review the updated Accreditation Council for Graduate Medical Education milestones for CNP fellowships to align curricula and identify learning gaps.
- New Patient Care milestones emphasize telemedicine and intraoperative monitoring, crucial areas for modern neurophysiology practice.
- The revised milestones acknowledge that not all fellows may achieve Level 4 competency in every area by graduation, stressing the importance of individual program goals.
