Applying the milestones in an internal medicine residency program curriculum: a foundation for outcomes-based learner assessment under the next accreditation system.
In 2010, University of Kansas Medical Center internal medicine residency program leaders concluded that their competency-based curriculum and evaluation system was not sufficient to promote accurate assessment of learners' performance and needed revision to meet the requirements of the Accreditation Council for Graduate Medical Education (ACGME) Next Accreditation System (NAS). Evaluations of learners seldom referenced existing curricular goals and objectives and reflected an "everyone is exceptional, no one is satisfactory" view.The authors identified the American Board of Internal Medicine and ACGME's Developmental Milestones for Internal Medicine Residency Training as a published standard for resident development. They incorporated the milestones into templates, a format that could be modified for individual rotations. A milestones-based curriculum for each postgraduate year of training and every rotation was then created, with input from educational leaders within each division in the Department of Internal Medicine and with the support of the graduate medical education office.In this article, the authors share their implementation process, which took approximately one year, and discuss their current work to create a documentation system for direct observation of entrustable professional activities, with the aim of providing guidance to other programs challenged with developing an outcomes-based curriculum and assessment system within the time frame of the NAS.
Dr. Lowry is assistant professor, Department of Internal Medicine, and associate program director for compliance and programming, Internal Medicine Residency Program, University of Kansas Medical Center, Kansas City, Kansas. Dr. Vansaghi is associate professor, Department of Internal Medicine, and program director, Internal Medicine Residency Program, University of Kansas Medical Center, Kansas City, Kansas. Dr. Rigler is professor, Department of Internal Medicine, and director, Office of Scholarly, Academic and Research Mentoring, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas. Dr. Stites is Peter T. Bohan Professor and Chair, Department of Internal Medicine, University of Kansas School of Medicine, and senior associate dean for clinical affairs, University of Kansas Medical Center, Kansas City, Kansas.
Becky N
BN
Lowry
Lisa M
LM
Vansaghi
Sally K
SK
Rigler
Steven W
SW
Stites
D000068:Accreditation / Q000592:standards*; D003162:Competency-Based Education; D003479:Curriculum / Q000592:standards* / Q000639:trends; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D017145:Models, Educational