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Evaluation of the teaching process enables the nurse to determine if the patient's learning needs were met and if training was effective. If the expected outcomes are not met, the care plan is revised, and additional education or reinforcement is provided. Nurses can ask questions after the session or obtain feedback to assess the patient's understanding of the topic.
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ACGME Milestones in the Real World: A Qualitative Study Exploring Response Process Evidence.

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Area of Science:

  • Medical Education Research
  • Graduate Medical Education
  • Program Evaluation

Background:

  • The Accreditation Council for Graduate Medical Education (ACGME) introduced the Milestones in 2013.
  • Validity evidence for Milestones has grown, but the response process remains under-explored.
  • A gap exists in understanding how Clinical Competency Committee (CCC) members assign Milestone ratings.

Purpose of the Study:

  • To qualitatively explore validity evidence related to the response process of individual CCC members.
  • To understand the decision-making process when assigning Milestone ratings to residents.

Main Methods:

  • Thematic analysis of semi-structured interviews with 8 Transitional Year (TY) CCC members from 4 programs.
  • Interviews were conducted immediately following CCC meetings between November and December 2020.
  • Iterative analysis involved coding, constant comparison, and theming.

Main Results:

  • CCC members reported a lack of formal training on Milestones.
  • Milestones were perceived primarily as tools for resident assessment, not program evaluation.
  • Rating assignment involved comparing resident data to peers and training duration; absent data led to assumed averages.

Conclusions:

  • The response process of TY CCC members was not consistently aligned with the dual purpose of Milestones.
  • The findings suggest a need to enhance training and emphasize the program evaluation role of Milestones.
  • Ensuring consistent application of Milestones is crucial for improving both resident and program outcomes.