Milestones Evaluation Tools
Gregory J. Zipfel, MD
Resident Evaluations
• Options
– Likert Scale Evaluations + Milestones
• Very lengthy
– Milestones alone
• Lengthy
• Not recommended by ACGME (reporting tool)
– Develop Milestone-based evaluations
• Neurosurgery chose this option
Milestone-based Evaluations
• Milestones Working Group
– Goals
• Make our assessment tools Milestone-specific
Milestone-based Evaluations
• Milestones Working Group
– Goals
• Make our assessment tools Milestone-specific
• Assist the PD and PC in drafting milestone levels
prior to CCC meeting
Milestone-based Evaluations
• Milestones Working Group
– Goals
• Make our assessment tools Milestone-specific
• Assist the PD and PC in drafting milestone levels
prior to CCC meeting
• Provide consistency in evaluation of residents
between programs
Milestone-based Evaluations
• Milestones Working Group
– Method
• Avoid numerical scales
Milestone-based Evaluations
• Milestones Working Group
– Method
• Avoid numerical scales
• Utilize the language of the milestones
Milestone-based Evaluations
• Milestones Working Group
– Method
• Avoid numerical scales
• Utilize the language of the Milestones
• Include the opportunity for narrative comment
Example
Example
3 evaluation questions?
Example
3 evaluation questions?
No! – covered by 1
Example – Evaluation question
• Work-up and treatment plan for patients
with ischemic and hemorrhagic stroke
Not observed
Unsatisfactory
Initiates work-up
✓
Formulates work-up and treatment plan
Formulates plan for patient with comorbidities
Example
✓
Impressions to Date
• Establishing a baseline for each resident has
been difficult; likely lacks accuracy
• High burden on faculty
– Baseline evaluations – time consuming
– Rotation evaluations – 50% more compared to past system
• High burden on PC
– Implementing new evaluation process
– Translating Milestone-based evaluations to Milestones
currently manual process
• Extra burden on PD
– Implementing new evaluation process
– Pre-CCC / CCC meeting preparations
Impressions to Date
• Value of Milestones likely to come gradually
over years
– Accuracy of individual resident evaluations will improve
over time
– Faculty will become more familiar with items included in
Milestones
– Institutional and national comparative data will become
available over time
Thanks