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Pediatric emergency medicine fellows’ milestone evaluations: Do they all meet the targets for graduation?
Author(s) -
Roskind Cindy G.,
Leonard Kathryn,
Baghdassarian Aline,
Kou Maybelle,
Levasseur Kelly,
Rose Jerri A.,
Shabanova Veronika,
Vu Tien,
Zuckerbraun Noel S.,
Langhan Melissa L.
Publication year - 2021
Publication title -
aem education and training
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 9
ISSN - 2472-5390
DOI - 10.1002/aet2.10620
Subject(s) - milestone , graduation (instrument) , medicine , medical education , cohort , pediatric emergency medicine , family medicine , emergency department , engineering , nursing , mechanical engineering , archaeology , emergency physician , history
Background The ACGME Milestone Project created a competency‐based trainee assessment tool. Subcompetencies (SCs) are scored on a 5‐point scale; level 4 is recommended for graduation. The 2018 Milestones Report found that across subspecialties, not all graduates attain level 4 for every SC. Objective The objective was to describe the number of pediatric emergency medicine (PEM) fellows who achieve ≥ level 4 in all 23 SCs at graduation and identify SCs where level 4 is not achieved and factors predictive of not achieving a level 4. Methods This is a multicenter, retrospective cohort study of PEM fellows from 2014 to 2018. Program directors provided milestone reports. Descriptive analysis of SC scores was performed. Subanalyses assessed differences in residency graduation scores, first‐year fellowship scores, and the rate of milestone attainment between fellows who did and did not attain ≥ level 4 at graduation. Results Data from 392 fellows were obtained. There were no SCs in which all fellows attained ≥ level 4 at graduation; the range of fellows scoring < level 4 per SC was 7% to 39%. A total of 67% of fellows did not attain ≥ level 4 on one or more SC. While some fellows failed to attain ≥ level 4 on up to all 23 SCs, 26% failed to meet level 4 on only one or two. In 19 SCs, residency graduation and/or first year fellow scores were lower for fellows who did not attain ≥ level 4 at graduation compared to those who did (mean difference = 0.74 points). Among 10 SCs, fellows who did not attain ≥ level 4 at graduation had a faster rate of improvement compared to those who did attain ≥ level 4. Conclusion In our sample, 67% of PEM fellows did not attain level 4 for one or more of the SCs at graduation. Low scores during residency or early in fellowship may predict difficulty in meeting level 4 by fellowship completion.