title: Have First-Year Emergency Medicine Residents Achieved Level 1 on Care-Based Milestones?
abstract: BACKGROUND
  Residents in Accreditation Council for Graduate Medical Education accredited emergency medicine (EM) residencies were assessed on 23 educational milestones to capture their progression from medical student level (Level 1) to that of an EM attending physician (Level 5). Level 1 was conceptualized to be at the level of an incoming postgraduate year (PGY)-1 resident; however, this has not been confirmed.
  
  
  OBJECTIVE
  Our primary objective in this study was to assess incoming PGY-1 residents to determine what percentage achieved Level 1 for the 8 emergency department (ED) patient care-based milestones (PC 1-8), as assessed by faculty. Secondary objectives involved assessing what percentage of residents had achieved Level 1 as assessed by themselves, and finally, we calculated the absolute differences between self- and faculty assessments.
  
  
  METHODS
  Incoming PGY-1 residents at 4 EM residencies were assessed by faculty and themselves during their first month of residency. Performance anchors were adapted from ACGME milestones.
  
  
  RESULTS
  Forty-one residents from 4 programs were included. The percentage of residents who achieved Level 1 for each subcompetency on faculty assessment ranged from 20% to 73%, and on self-assessment from 34% to 92%. The majority did not achieve Level 1 on faculty assessment of milestones PC-2, PC-3, PC-5a, and PC-6, and on self-assessment of PC-3 and PC-5a. Self-assessment was higher than faculty assessment for PC-2, PC-5b, and PC-6.
  
  
  CONCLUSIONS
  Less than 75% of PGY-1 residents achieved Level 1 for ED care-based milestones. The majority did not achieve Level 1 on 4 milestones. Self-assessments were higher than faculty assessments for several milestones.
authors.forename: Moshe
authors.initials: M
authors.lastname: Weizberg
authors.forename: Michael C
authors.initials: MC
authors.lastname: Bond
authors.forename: Michael
authors.initials: M
authors.lastname: Cassara
authors.forename: Christopher
authors.initials: C
authors.lastname: Doty
authors.forename: Jason
authors.initials: J
authors.lastname: Seamon
mesh_terms: D000068:Accreditation; D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D004503:Education, Medical, Graduate; D004521:Educational Measurement / Q000379:methods*; D004635:Emergency Medicine / Q000193:education* / Q000592:standards; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D008297:Male; D012647:Self-Assessment; D014481:United States