ArticleAcademic medicine : journal of the Association of American Medical Colleges2019
A National Study of Longitudinal Consistency in ACGME Milestone Ratings by Clinical Competency Committees: Exploring an Aspect of Validity in the Assessment of Residents' Competence.
Article in Academic medicine : journal of the Association of American Medical Colleges, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Construct Validity Evidence for ACGME Milestones in Surgical Specialties: A Systematic Review.Journal of graduate medical education · 2025Pooled it
- Development and application of an intelligent assessment system for medical clinical skill training.NPJ digital medicine · 2026Article
- Approaches to the Evaluation of Competency-Based Health Professions Education Implementation from Around the Globe.Perspectives on medical education · 2026Article
- Programmatic assessment and competency development in postgraduate medical education: a systematic review and narrative synthesis.Frontiers in medicine · 2026Article
- Trainee-Physician Milestones Ratings and Patient Experience Surveys in Early Unsupervised Practice.JAMA network open · 2025Article
- Program Effects as a Source of Construct-Irrelevant Variance in ACGME Milestone Ratings.Journal of graduate medical education · 2025Article
- Delineating Neurosurgery Resident Development: Insights from a 10-Year National Accreditation Council for Graduate Medical Education Milestones and Learning Trajectories.Neurosurgery · 2025Article
- Investigating the Roles and Impact of Clinical Competency Committees in Graduate Medical Education: A Narrative Review.Journal of graduate medical education · 2024Review
- Beyond the requirement: A novel patient follow-up report.AEM education and training · 2024Article
- Emergency Medicine Milestones Final Ratings Are Often Subpar.The western journal of emergency medicine · 2024Article
- Academic Achievement and Competency in Rural and Urban Family Medicine Residents.Family medicine · 2023Article
- Assessment of Agenda Setting With ACGME Milestones in Family Medicine Residents.Family medicine · 2023Article
- Reimagining the Clinical Competency Committee to Enhance Education and Prepare for Competency-Based Time-Variable Advancement.Journal of general internal medicine · 2022Review
- ACGME Milestones in the Real World: A Qualitative Study Exploring Response Process Evidence.Journal of graduate medical education · 2022Article
- Longitudinal Reliability of Milestones-Based Learning Trajectories in Family Medicine Residents.JAMA network open · 2021Article
- Article
- Assessing the Transition of Training in Health Systems Science From Undergraduate to Graduate Medical Education.Journal of graduate medical education · 2021Article
- Association Between Internal Medicine Residency Applicant Characteristics and Performance on ACGME Milestones During Intern Year.Journal of graduate medical education · 2021Article
- The Science of Effective Group Process: Lessons for Clinical Competency Committees.Journal of graduate medical education · 2021Article
- A Validity Framework for Effective Analysis and Interpretation of Milestones Data.Journal of graduate medical education · 2021Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo investigate whether clinical competency committees (CCCs) were consistent in applying milestone ratings for first-year residents over time or whether ratings increased or decreased.
methodBeginning in December 2013, the Accreditation Council for Graduate Medical Education (ACGME) initiated a phased-in requirement for reporting milestones; emergency medicine (EM), diagnostic radiology (DR), and urology (UR) were among the earliest reporting specialties. The authors analyzed CCC milestone ratings of first-year residents from 2013 to 2016 from all ACGME-accredited EM, DR, and UR programs for which they had data. The number of first-year residents in these programs ranged from 2,838 to 2,928 over this time period. The program-level average milestone rating for each subcompetency was regressed onto the time of observation using a random coefficient multilevel regression model.
resultsNational average program-level milestone ratings of first-year residents decreased significantly over the observed time period for 32 of the 56 subcompetencies examined. None of the other subcompetencies showed a significant change. National average in-training examination scores for each of the specialties remained essentially unchanged over the time period, suggesting that differences between the cohorts were not likely an explanatory factor.
conclusionsThe findings indicate that CCCs tend to become more stringent or maintain consistency in their ratings of beginning residents over time. One explanation for these results is that CCCs may become increasingly comfortable in assigning lower ratings when appropriate. This finding is consistent with an increase in confidence with the milestone rating process and the quality of feedback it provides.
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