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

3 evaluation questions?

Example

3 evaluation questions?

No! – covered by 1

Example

Example – Evaluation question

• Work-up and treatment plan for patients with ischemic and hemorrhagic strokeNot observedUnsatisfactoryInitiates work-upFormulates work-up and treatment planFormulates plan for patient with co-

morbidities

✓

✓

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