American College of Emergency Physicians
Academic Affairs Subcommittee on Milestones
Conference Call
February 20, 2013
MINUTES DRAFT
Participants
Mary Jo Wagner, MD, FACEP, Subcommittee Chair; Daniel Cabrera, MD; Mary Ann Edens, MD,
FACEP; Doug Franzen, MD, FACEP; Nicholas Nacca, MD; Samuel Luber, MD, MPH, FACEP; and
Nestor S. Rodriguez, MD.
Others participating on the call: Marjorie Geist, RN, PhD, CAE, Staff Liaison.
Agenda
1. Resident survey
2. Milestones status reports
3. JMTF meeting at CORD
4. Other
Major Points Discussed
1. Dr. Nacca will send a survey on milestones to EMRA’s recent leaders and potentially to all
EMRA members to ascertain their perceptions on milestone training they have or are receiving.
The survey will be sent by the end of March.
2. Dr. Luber reported on the status of milestones 16 – professional values (PROF1) and 17 –
accountability (PROF2): literature search indicates there are non-medical evaluation tools but
these tools are not validated; Dr. Franzen sent information on the United Kingdom’s
standardized situational judgment test for review and consideration. Other evaluation tools for
consideration include 360o evaluation, critical incidence evaluation tool, and standardized direct
observation tools (SDOTs). He noted that it is difficult to differentiate between the five levels and
consideration should be given to combining the assessment tools for professional values and
accountability because of overlapping criteria. Dr. Luber also indicated the need to eventually
validate these evaluation tools.
Dr. Wagner reported on the status of milestones 18 – patient centered communication (ICS1) and
19 – team management (ICS2): potential evaluation tools include SDOT, team simulation rating
scales, 360o evaluation, and assessment using death notification criteria. She also noted that
aviation behavioral evaluation tools should be explored.
Dr. Guth provided a written report on the status of milestones 20 – practice based performance
improvement (PBL1) and 21 – patient safety (SBP1): consider that residents should take an active
role in review of their own cases and quality assurance processes within emergency departments
and hospitals; not every resident would necessarily perform the same performance improvement
activity but likely they would need several options from which to choose.
A. Experiential based milestones - This is likely to be best captured through a portfolio of
activities that the resident completed specific to the hospital and emergency department
that they work in.
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Patient Safety and Quality Improvement Conference
Quality Review Committee Participation
Peer Case Review Committee
Creation of Clinical Pathways for Specific Conditions (ie stroke, PNA, etc)
Root Cause Analysis Committee of Medical Errors
Academic Affairs Subcommittee on Milestones
February 20, 2013
Page 2
B. Additional patient safety and quality improvement training - there also could be
additional educational conferences that focus on optimization of ED function or quality
improvement and patient safety; following are a few examples.
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IHI Open School certificate and courses
http://www.ihi.org/offerings/IHIOpenSchool/Courses/Pages/default.aspx
Telluride Patient Safety Conference for Residents and Medical Students
http://educatetheyoung.wordpress.com/2012/11/27/telluride-patient-safety-educationalroundtable-and-summer-camps-for-2013/
VA Resident Training Courses
http://www.patientsafety.gov/curriculum/index.html
In addition to Dr. Guth’s report, Dr. Franzen will provide information on SAEM’s consensus
conference on PBLI.
Dr. Edens provided a status report on milestones 22 – systems-based management (SBP2) and
23 – technology (SBP3): there are no validated systems-based or technology evaluation tools.
Their recommendations are to explore using SDOT, objective structured clinical exam (OSCE),
and 360o evaluation. Dr. Jonathan Heidt will submit his summary relating to these issues.
3. The Joint Milestones Task Force (JMTF) will be meeting during CORD’s Academic Assembly
on Wednesday, March 6, from 11:30 am – 1:00 pm in the Spruce room; CORD members will be
encouraged to attend and participate in this meeting. JMTF sub-group chairs will briefly present
on each subgroup’s activities. Members working on this subgroup should submit their material
to Dr. Wagner before the CORD meeting.
4. The next conference call will occur after the CORD meeting during the week of March 11.
Name
Felix Ankel
Steven Bird
Daniel Cabrera
Robert Cooney
Mary Ann Edens
Douglas S Franzen
Todd Guth
Jonathan Heidt
Laura Hopson
Hans House
Bryan Judge
Chadd K. Kraus
Samuel Luber
Nicholas Nacca
Cynthia Price
Nestor Rodriguez
Jeff Siegelman
Mary Jo Wagner
Institution
Regions Hospital
University of Massachusetts
Mayo
Conemaugh Memorial Medical Center
LSU - Shreveport
Virginia Commonwealth University
Denver
Washington University in St. Louis
University of Michigan
Iowa
Grand Rapids
Marjorie Geist
Nissi George
ACEP
ACEP
University of Texas - Houston
SUNY Upstate
Hartford Hospital
University of Wisconsin
Emory
Central Michigan University
Email
felixankel@gmail.com
steven.bird@umassmemorial.org
cabrera.daniel@mayo.edu
cooneyrr@icloud.com
medens@lsuhsc.edu
franzend@vcu.edu
todd.guth@ucdenver.edu
heidtj@wustl.edu
lhopson@med.umich.edu
hans-house@uiowa.edu
bryan.judge@spectrumhealth.org
kraus.emra@gmail.com
Samuel.D.Luber@uth.tmc.edu
naccan@upstate.edu
ccprice@harthosp.org
nsrodrig@medicine.wisc.edu
jsiegelman@emory.edu
mjwagner@cris.com