Competency-Based Resident Education, Milestones, and Simulation [19B]

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Nearly 4 years ago the Accreditation Council for Graduate Medical Education launched the competency-based Milestones process for GME program accreditation and assessment of medical residents. In general, specific milestone sub-competency components must be mapped to a simulation scenario's objectives and actions. It is suggested that this approach would lead to expansion of summative simulation exercises, rather than the current formative focus. This mapping is far more complex than might be imagined and the evaluation metric for simulation scenarios would be shifted from current methods to new approaches. This is an overview of the ACGME Milestones integration in simulation-based learning.


Our study shows the process of integration of Milestones in evaluation during a summative simulation exam for 40 residents in an OB/GYN residency program and its usefulness in evaluation of residents during Clinical Competency Committee meetings. The process will include mapping particular milestones to critical actions of a task-specific simulation, creation of a grading tool that includes milestones with critical actions, and using the results of the grading tool during Clinical Competency Committee meetings.


Based on our integration of Milestones into our simulation skills lab, we will have a process of competency-based assessment that includes the ACGME Milestones in resident medical education. We will be able to report on coding of simulation exercises in accordance with milestones and the initial reactions of Clinical Competency Committee members to the availability of milestones-coded simulation results.


Milestones can be integrated into simulation-based learning and be a useful tool during Clinical Competency Committee meetings.

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