Evidence map›Paper›PMID 33936531›Full record

ArticleJournal of graduate medical education2021

Stages of Milestones Implementation: A Template Analysis of 16 Programs Across 4 Specialties.

Nicholas A Yaghmour, Lauren J Poulin, Elizabeth C Bernabeo, Andem Ekpenyong, Su-Ting T Li, Aimee R Eden, Karen E Hauer, Aleksandr M Tichter, Stanley J Hamstra, Eric S Holmboe

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In one paragraph

Article in Journal of graduate medical education, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Cost and Challenges of Clinical Competency Committees and Milestones Assessment.Journal of medical education and curricular development
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Nicholas A Yaghmouris Associate Director, Milestones and Well-Being Research, Physician Engagement, Recruitment, and Wellness, Accreditation Council for Graduate Medical Education (ACGME).
Lauren J Poulinis Milestones Administrator, Milestones Department, ACGME.
Elizabeth C Bernabeois Research Consultant, ACGME.
Andem Ekpenyongis Associate Professor, Department of Internal Medicine, Rush University Medical Center.
Su-Ting T Liis Professor, Vice-Chair of Education, and Residency Program Director, Division of Pediatric Hospital Medicine, Department of Pediatrics, University of California Davis.
Aimee R Edenis Medical Anthropologist, American Board of Family Medicine.
Karen E Haueris Associate Dean, Competency Assessment and Professional Standards, and Professor of Medicine, University of California, San Francisco.
Aleksandr M Tichteris Assistant Professor Program Director, Department of Emergency Medicine, Baylor College of Medicine; at the time of research.
Stanley J Hamstrawas Vice President, Milestones Research and Evaluation, ACGME, and is now Professor, Department of Surgery, University of Toronto, Adjunct Professor, Department of Medical Education, Feinberg School of Medicine, Northwestern University, and Research Consultant, ACGME.
Eric S Holmboeis Chief Research, Milestone Development, and Evaluation Officer, ACGME.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSince 2013, US residency programs have used the competency-based framework of the Milestones to report resident progress and to provide feedback to residents. The implementation of Milestones-based assessments, clinical competency committee (CCC) meetings, and processes for providing feedback varies among programs and warrants systematic examination across specialties.

objectiveWe sought to determine how varying assessment, CCC, and feedback implementation strategies result in different outcomes in resource expenditure and stakeholder engagement, and to explore the contextual forces that moderate these outcomes.

methodsFrom 2017 to 2018, interviews were conducted of program directors, CCC chairs, and residents in emergency medicine (EM), internal medicine (IM), pediatrics, and family medicine (FM), querying their experiences with Milestone processes in their respective programs. Interview transcripts were coded using template analysis, with the initial template derived from previous research. The research team conducted iterative consensus meetings to ensure that the evolving template accurately represented phenomena described by interviewees.

resultsForty-four individuals were interviewed across 16 programs (5 EM, 4 IM, 5 pediatrics, 3 FM). We identified 3 stages of Milestone-process implementation, including a resource-intensive early stage, an increasingly efficient transition stage, and a final stage for fine-tuning.

conclusionsResidency program leaders can use these findings to place their programs along an implementation continuum and gain an understanding of the strategies that have enabled their peers to progress to improved efficiency and increased resident and faculty engagement.

Indexed as

Internship and ResidencyPopulation HealthChildClinical CompetenceCompetency-Based EducationEducational MeasurementHumansInternal Medicine

Identifiers

PMID33936531
PMCPMC8078079

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.