Teaching Self-directed Learning Skills Through a Resident-Led Milestones Process

The Accreditation Council for Graduate Medical Education allows flexibility for resident roles in the Milestone assessment process. The University of Utah Family Medicine Residency implemented a resident-led Milestones process to cultivate the skill of self-assessment and promote resident ownership of their learning.

Residents were provided comprehensive evaluation data and asked to self-assess their competency on each Milestone, with input from their advisor. Residents presented their self-assessment to the Clinical Competency Committee, who then determined the final score for each Milestone. A 10-question survey examined perceptions of the resident-led Milestones process by residents and faculty. We calculated means and standard deviations (SD).

A total of 16 of 24 residents (67% response rate) and 12 of 14 faculty (86% response rate) completed the survey. Residents agreed most highly with the following statements: "I have good support from my advisor in being prepared to lead my Milestones meeting," "I am actively engaged in guiding the development of my own Milestones ratings," and "Leading my Milestones meeting assists me in accurately self-assessing my progress." Residents showed high agreement that "My final Milestones scores accurately reflect my behavior and level of knowledge." Residents rated the stress as low, in response to the statement, "My Milestones meeting is stressful for me." Faculty responses were similar but tended toward lower scores than residents.

The resident-led Milestones process engages residents actively in self-assessment. Residents and faculty believe the process provides accurate assessment results without undue stress; this process potentially increases residents' ability to understand their own learning needs and direct their own learning process.