Reporting Achievement of Medical Student Milestones to Residency Program Directors: An Educational Handover.
Competency-based education, including assessment of specialty-specific milestones, has become the dominant medical education paradigm; however, how to determine baseline competency of entering interns is unclear-as is to whom this responsibility falls. Medical schools should take responsibility for providing residency programs with accurate, competency-based assessments of their graduates.



A University of Michigan ad hoc committee developed (spring 2013) a post-Match, milestone-based medical student performance evaluation for seven students matched into emergency medicine (EM) residencies. The committee determined EM milestone levels for each student based on assessments from the EM clerkship, end-of-third-year multistation standardized patient exam, EM boot camp elective, and other medical school data.



In this feasibility study, the committee assessed nearly all 23 EM milestones for all seven graduates, shared these performance evaluations with the program director (PD) where each student matched, and subsequently surveyed the PDs regarding this pilot. Of the five responding PDs, none reported using the traditional medical student performance evaluation to customize training, four (80%) indicated that the proposed assessment provided novel information, and 100% answered that the assessment would be useful for all incoming trainees.



An EM milestone-based, post-Match assessment that uses existing assessment data is feasible and may be effective for communicating competency-based information about medical school graduates to receiving residency programs. Next steps include further aligning assessments with competencies, determining the benefit of such an assessment for other specialties, and articulating the national need for an effective educational handover tool between undergraduate and graduate medical education institutions.
C.B. Sozener is assistant professor, Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan. M.L. Lypson is associate chief of staff for education, Ann Arbor VA Healthcare System, professor, Department of Internal Medicine, and previously assistant dean, Graduate Medical Education, University of Michigan, Ann Arbor, Michigan. J.B. House is assistant professor, Department of Pediatrics and Communicable Diseases and Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan. L.R. Hopson is assistant professor, Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan. S.L. Dooley-Hash is adjunct clinical assistant professor, Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan. S. Hauff is assistant professor, Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan. M. Eddy is house officer, Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan. J.P. Fischer is a graduate, School of Public Health, University of Michigan, Ann Arbor, Michigan. S.A. Santen is assistant dean for educational research and quality improvement, University of Michigan Medical School, and professor, Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan.
Cemal B
CB
Sozener
Monica L
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Lypson
Joseph B
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House
Laura R
LR
Hopson
Suzanne L
SL
Dooley-Hash
Samantha
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Hauff
Mary
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Eddy
Jonathan P
JP
Fischer
Sally A
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Santen
D000124:Achievement; D002983:Clinical Competence; D003162:Competency-Based Education; D004504:Education, Medical, Undergraduate / Q000379:methods / Q000592:standards*; D004521:Educational Measurement / Q000379:methods* / Q000592:standards; D004635:Emergency Medicine / Q000193:education; D005180:Faculty, Medical; D005240:Feasibility Studies; D006801:Humans; D007396:Internship and Residency; D008824:Michigan; D010865:Pilot Projects; D013337:Students, Medical