A Survey of Ultrasound Milestone Incorporation Into Emergency Medicine Training Programs.
OBJECTIVE
With the introduction of the Emergency Medicine Milestone Project in 2013, residencies now assess emergency ultrasound (US) skills at regular intervals. However, it is unclear how programs are implementing the emergency US milestones and assessing competency. With the use of the milestone tool, a survey was distributed to emergency US educators to determine when programs are providing emergency US education, when residents are expected to attain competency, and whether the milestones reflect their expectations of trainees.


METHODS
We conducted a prospective cross-sectional survey study distributed electronically to designated emergency US experts at 169 programs. Participants were queried on education and competency evaluation within the context of the milestones by designating a postgraduate year when the 5 milestone levels were taught and competency was expected. Survey findings were reported as percentages of total respondents from descriptive statistics.


RESULTS
Responses were received from 53% of programs, and 99% were familiar with the milestones. Most programs provide level 1 (88%) and 2 (85%) instruction during postgraduate year 1. Most programs expect level 1 competency before residency (61%) and expect mastery of level 2 by the end of postgraduate year 1 (60%). Sixty-two percent believe the milestones do not accurately reflect their expectations, citing insufficient minimum scan numbers, lack of specificity, and unattainable level 5 requirements.


CONCLUSIONS
There is substantial variability in the frequency and methods of competency evaluation using the emergency US milestones. However, most responders agree that residents should obtain level 2 competency by postgraduate year 1. Variation exists regarding what year and what skills define level 3 or greater competency.
Emergency Services Institute, Cleveland Clinic, Cleveland, Ohio USA courtney.smalley@gmail.com.
Courtney M
CM
Smalley
Department of Emergency Medicine, University of California Davis, Sacramento, California USA.
Alyrene
A
Dorey
Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado USA. Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado USA.
Molly
M
Thiessen
Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado USA. Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado USA.
John L
JL
Kendall
D002983:Clinical Competence / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate / Q000379:methods; D004521:Educational Measurement / Q000706:statistics & numerical data; D004635:Emergency Medicine / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014465:Ultrasonics / Q000193:education*; D014463:Ultrasonography / Q000379:methods*
milestones; resident education; ultrasound competency; ultrasound education