title: Initial Comparison of Resident and Attending Milestones Evaluations in Plastic Surgery.
abstract: BACKGROUND
  Graduate medical education has recently undergone a major archetypal shift toward competency-based evaluations of residents' performance. The implementation of the Milestones program by the Accreditation Council for Graduate Medical Education (ACGME) is a core component of the shift, designed to ensure uniformity in measuring residency knowledge using a series of specialty-specific achievements. This study evaluates the correlation between residents' self-evaluations and program directors' assessments of their performance.
  
  
  METHODS
  The study population comprised 12 plastic surgery residents, ranging from postgraduate year 1 to postgraduate year 6, enrolled in an integrated residency program at a single institution.
  
  
  RESULTS
  Overall, average attending scores were lower than average resident scores at all levels except postgraduate year 6. Correlation between resident and attending evaluations ranged from 0.417 to 0.957, with the correlation of average scores of Patient Care (0.854) and Medical Knowledge (0.816) Milestones significantly higher than those of professional skillsets (0.581). "Patient care, facial esthetics" was the Milestone with the lowest average scores from both groups. Residents scored themselves notably higher than their attendings' evaluations in Practice-based Learning and Improvement categories (+0.958) and notably lower in Medical Knowledge categories such as "Cosmetic Surgery, Trunk and Lower Extremities" (-0.375) and "Non-trauma hand" (-0.208). The total possible number of participants in this study was 12. The actual number of participants was 12 (100%).
  
  
  CONCLUSIONS
  The remarkable range of correlations suggests that expectations for performance standards may vary widely between residents and program directors. Understanding gaps between expectations and performance is vital to inform current and future residents as the restructuring of the accreditation process continues.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Icahn School of Medicine, New York, New York.
authors.forename: Amy
authors.initials: A
authors.lastname: Yao
authors.affiliation: Division of Plastic and Reconstructive Surgery, Icahn School of Medicine, New York, New York.
authors.forename: Benjamin B
authors.initials: BB
authors.lastname: Massenburg
authors.affiliation: Division of Plastic and Reconstructive Surgery, Icahn School of Medicine, New York, New York.
authors.forename: Lester
authors.initials: L
authors.lastname: Silver
authors.affiliation: Division of Plastic and Reconstructive Surgery, Icahn School of Medicine, New York, New York. Electronic address: peter.taub@mountsinai.org.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Taub
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002983:Clinical Competence; D003162:Competency-Based Education / Q000458:organization & administration*; D004503:Education, Medical, Graduate / Q000458:organization & administration; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008297:Male; D015397:Program Evaluation; D012647:Self-Assessment; D013518:Surgery, Plastic / Q000193:education*; D014481:United States
keywords: Interpersonal and Communication Skills; Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; Professionalism; Systems-Based Practice; education; milestones; programs; resident