title: Uniting Evidence-Based Evaluation with the ACGME Plastic Surgery Milestones: A Simple and Reliable Assessment of Resident Operative Performance.
abstract: BACKGROUND
  Milestones evaluations in plastic surgery reflect a shift toward competency-based training but have created a number of challenges. The authors have incorporated the smartphone application evaluation tool, System for Improving and Measuring Procedural Learning (SIMPL), that was recently developed by a multi-institutional research collaborative. In this pilot study, the authors hypothesize that SIMPL can improve resident evaluation and also collect granular performance data to simplify compliance with the plastic surgery Milestones.
  
  
  METHODS
  SIMPL was prospectively piloted with a plastic surgery resident and faculty surgeon at Massachusetts General Hospital in this institutional review board-approved study. The study period was a 2-month interval corresponding to the resident's rotation.
  
  
  RESULTS
  The resident-faculty combination performed 20 cases together. All cases were evaluated with SIMPL. SIMPL evaluations uniformly took under 1 minute to submit. The average time to completed evaluation from surgery completion was 5 hours (<0.5 hour to 12 hours). Concrete, objective, and specific data about resident performance were collected for every case and presented in a concise format.
  
  
  CONCLUSIONS
  SIMPL is an innovative, evidence-based evaluation system that makes performance assessment feasible for every procedure in which a plastic surgery resident participates. SIMPL's competency-based framework can be easily scaled to facilitate data collection and reporting of mandatory Milestones evaluations at the program and national levels. This technology will support a shared vocabulary between residents and faculty to enhance intraoperative education.
authors.affiliation: Boston, Mass.; and Seattle, Wash.|From the Division of Plastic and Reconstructive Surgery and the Department of Surgery, Massachusetts General Hospital, Harvard Medical School; and the Department of Surgery, Harborview Medical Center, University of Washington.
authors.forename: Edward M
authors.initials: EM
authors.lastname: Kobraei
authors.affiliation: Boston, Mass.; and Seattle, Wash.|From the Division of Plastic and Reconstructive Surgery and the Department of Surgery, Massachusetts General Hospital, Harvard Medical School; and the Department of Surgery, Harborview Medical Center, University of Washington.
authors.forename: Jordan D
authors.initials: JD
authors.lastname: Bohnen
authors.affiliation: Boston, Mass.; and Seattle, Wash.|From the Division of Plastic and Reconstructive Surgery and the Department of Surgery, Massachusetts General Hospital, Harvard Medical School; and the Department of Surgery, Harborview Medical Center, University of Washington.
authors.forename: Brian C
authors.initials: BC
authors.lastname: George
authors.affiliation: Boston, Mass.; and Seattle, Wash.|From the Division of Plastic and Reconstructive Surgery and the Department of Surgery, Massachusetts General Hospital, Harvard Medical School; and the Department of Surgery, Harborview Medical Center, University of Washington.
authors.forename: John T
authors.initials: JT
authors.lastname: Mullen
authors.affiliation: Boston, Mass.; and Seattle, Wash.|From the Division of Plastic and Reconstructive Surgery and the Department of Surgery, Massachusetts General Hospital, Harvard Medical School; and the Department of Surgery, Harborview Medical Center, University of Washington.
authors.forename: Keith D
authors.initials: KD
authors.lastname: Lillemoe
authors.affiliation: Boston, Mass.; and Seattle, Wash.|From the Division of Plastic and Reconstructive Surgery and the Department of Surgery, Massachusetts General Hospital, Harvard Medical School; and the Department of Surgery, Harborview Medical Center, University of Washington.
authors.forename: William G
authors.initials: WG
authors.lastname: Austen
authors.affiliation: Boston, Mass.; and Seattle, Wash.|From the Division of Plastic and Reconstructive Surgery and the Department of Surgery, Massachusetts General Hospital, Harvard Medical School; and the Department of Surgery, Harborview Medical Center, University of Washington.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Liao
mesh_terms: D000068:Accreditation; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D004521:Educational Measurement / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008404:Massachusetts; D010865:Pilot Projects; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000193:education*; D013518:Surgery, Plastic / Q000193:education*