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