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Education| Volume 47, ISSUE 4, P432-440, October 2014

Practicing Emergency Physicians Report Performing Well on Most Emergency Medicine Milestones

Published:July 07, 2014DOI:https://doi.org/10.1016/j.jemermed.2014.04.032
Practicing Emergency Physicians Report Performing Well on Most Emergency Medicine Milestones
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      Abstract

      Background

      The Accreditation Council for Graduate Medical Education's Next Accreditation System endorsed specialty-specific milestones as the foundation of an outcomes-based resident evaluation process. These milestones represent five competency levels (entry level to expert), and graduating residents will be expected to meet Level 4 on all 23 milestones. Limited validation data on these milestones exist. It is unclear if higher levels represent true competencies of practicing emergency medicine (EM) attendings.

      Objective

      Our aim was to examine how practicing EM attendings in academic and community settings self-evaluate on the new EM milestones.

      Methods

      An electronic self-evaluation survey outlining 9 of the 23 EM milestones was sent to a sample of practicing EM attendings in academic and community settings. Attendings were asked to identify which level was appropriate for them.

      Results

      Seventy-nine attendings were surveyed, with an 89% response rate. Sixty-one percent were academic. Twenty-three percent (95% confidence interval [CI] 20%−27%) of all responses were Levels 1, 2, or 3; 38% (95% CI 34%−42%) were Level 4; and 39% (95% CI 35%−43%) were Level 5. Seventy-seven percent of attendings found themselves to be Level 4 or 5 in eight of nine milestones. Only 47% found themselves to be Level 4 or 5 in ultrasound skills (p = 0.0001).

      Conclusions

      Although a majority of EM attendings reported meeting Level 4 milestones, many felt they did not meet Level 4 criteria. Attendings report less perceived competence in ultrasound skills than other milestones. It is unclear if self-assessments reflect the true competency of practicing attendings. The study design can be useful to define the accuracy, precision, and validity of milestones for any medical field.

      Keywords

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      Article info

      Publication history

      Published online: July 07, 2014
      Accepted: April 28, 2014
      Received in revised form: January 30, 2014
      Received: October 2, 2013

      Footnotes

      This study was exempt from our hospital's Institutional Review Board.

      Identification

      DOI: https://doi.org/10.1016/j.jemermed.2014.04.032

      Copyright

      © 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.

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