Related Experiment Video
Updated: Jan 13, 2026

Setup and Execution of the Rapid Cycle Deliberate Practice Death Notification Curriculum
Published on: August 5, 2020
Exploring Program Differences in ACGME Milestone 2.0 Ratings: Interpersonal and Communication Skills and
Shaghayegh Sabbaghan Kermani1, Claire Ferguson2, Jonathan Greer1
1Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
Objective:
To explore program-level variations in ACGME Milestone 2.0 ratings for Interpersonal & Communication Skills (ICS) and Professionalism (PROF) in general surgery residency programs.
Design:
Descriptive analysis of milestone 2.0 ratings using intraclass correlation coefficients (ICCs) to assess program-level variation at each PGY level across ICS and PROF sub-competencies. Wilcoxon Rank Sum tests were conducted to compare program sizes between uniform and nonuniform rating programs.
Setting:
General surgery residency programs across the United States during the 2020 to 2021 academic year.
Participants:
About 7,581 residents in PGY1 through PGY5 from 328 general surgery residency programs.
Results:
Analysis of descriptive statistics highlighted considerable variation across programs. Analysis of ICC revealed that program-level differences contributed to 0.298 to 0.713 of the total variance in milestone ratings. ICCs were highest in PGY1 and PGY5 residents, suggesting stronger program influence at the start and end of residency. Uniform rating-where all residents at a given PGY level received the same rating-was common, particularly in PGY1 and PGY5, occurring in up to 41.2% of programs. Programs with uniform patterns tended to be smaller in size.
Conclusions:
This study highlights substantial program-level variation in milestone ratings for ICS and PROF across all PGY levels in general surgery residency. High ICCs and uniform rating patterns suggest that milestone ratings may reflect institutional norms rather than resident performance. Future research should explore contributing factors and develop strategies to enhance fairness and quality in resident assessment.
Related Concept Videos
Levels of Communication I: Intrapersonal, Interpersonal, and Small Group
We can participate in these relationships through verbal, nonverbal, and mediated communication. We engage in verbal communication when we use words during our interaction to convey specific meanings. On the other hand, nonverbal communication refers to various factors that can impact how we understand each other—for example, facial expressions.
We interact with others using mediated technologies like the...
Barriers to Effective Communication II
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
Role of Communication in the Nursing Process III: Evaluation and Documentation
SBAR II: Application of SBAR
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
Role of Communication in the Nursing Process II: Planning and Implementation
Levels of Communication II: Organizational, Public, and Group Dynamics

