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Oral Milestone Assessment versus Electronic Evaluation (E-Value) Milestone Assessment-Is One Better Than Another?

Purpose: To compare milestones assigned to PGY 1 and 2 Residents via an Oral Milestone Exam versus the traditional retrospective monthly electronic evaluation system to assess how they aligned. 

Background: Programs are tasked with implementing assessment tools to evaluate the 28 milestones. Most programs use some form of an electronic evaluation at rotation completion. The Clinical Competency Committee reviews all information for final score assignment each six month period. 

Methods: In 2015, we instituted an Oral Milestone examination to assign the six-month milestones and compared those scores to our retrospective monthly on-line evaluations. We evaluated PGY 1 and 2 residents in a simulated forum on milestones, which included Medical Knowledge, Patient Care, and Interpersonal /Communication Skills Competencies. All residents were given simulated patients, cases, and/or skills while each examiner was given the specific ACGME milestone assessment sheet to score. The residents were provided with immediate feedback.

Results: From 2015-2018, 78.4% of PGY 1 and 43% of PGY 2 residents scored higher on the real-time oral milestone exam. Additionally, in 82% of PGY 1 residents and 52% of PGY 2 residents score on the oral exam was at 0.5-1milestone level higher than the retrospective electronic monthly evaluations.

Discussions: Clinical Competency Committees are tasked with Milestone assignment to all residents every six months. Evaluation tools that most reflect the actual milestone completion is a mission of all programs. We set out to assess whether our electronic monthly retrospective evaluation system was mirroring the assessment performed on our residents with the real-time oral milestone exams at the end of the six month interval, just prior to submission to the ACGME.


Our data suggests discrepancy in our online retrospective milestone evaluation versus the real-time assessment of an oral exam. Not only did residents score higher in most circumstances in an oral format, but they were higher by a half-whole milestone level in the majority of the cases. It would suggest that our ability as educators to recollect the performance of a resident at an interval later than the performance may be flawed.
Programs may want to consider instituting an oral milestone examination for enhanced milestone assessment.

Topics: General Ob-Gyn, Standardized Patient, Simulation, Assessment, GME, Professionalism, Medical Knowledge, Patient Care, Residency Director, Osteopathic Faculty, Faculty, Resident,

General Information


Intended
Audience
Resident,Faculty,Osteopathic Faculty,Residency Director,
Competencies
Addressed
Patient Care,Medical Knowledge,Professionalism,
Educational
Continuum
GME,
Educational
Focus
Assessment,Simulation,Standardized Patient,
Clinical Focus
General Ob-Gyn,

Author Information

Kourtnie McQuillen, MD, West Virginia University, Department of Obstetrics and Gynecology; Rahul Mannan, MS 4; Robert Shapiro, MD; Mahreen Hashmi, MD

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