The Implementation of ACGME ＂Reporting Milestones＂ in Internal Medicine Postgraduate Year Training Program - Experience Sharing and Preliminary Outcome

Purpose: Competency-based medical education has been the current trend of education, and milestones assessment is one of the means to practice it. We hereby shared our experience and preliminary results in applying reporting milestones in our postgraduate year (PGY) training program. Methods: We translated the English version of ＂reporting milestones＂ to Chinese one and built the electronic report worksheets on our web-system. Milestones assessments were conducted at the end of every month since August 2018. We analyzed the completion rate and the results of the assessments in the 2018 academic year by using IBM SPSS Statistics version 23. Results: The completion rate of milestones assessments was 96.7% (175/181), of which the most frequent unassessed subcompetencies were patient care (PC)-4 and PC-5 (both n = 9). The mean levels of the subcompetencies ranged from 3.5 to 4 on a scale of 1-5. Our PGY physicians demonstrated better in subcompetencies systems-based practice (SBP)-1, practice-based learning and improvement (PBLI)-1, and PBLI-3 (mean levels 4.0 ± 0.4, 4.0 ± 0.4, 4.0 ± 0.5, respectively), and worse in subcompetence SBP-3 (mean levels 3.5 ± 0.6) (p ＜ 0.05 by ANOVA). The progress of all subcompetencies between the first and third months of rotation course was insignificant. Conclusions: We accomplished the reporting milestones assessments in our hospital. Our experience in implementing milestones can be as a reference for other hospitals. The learning outcomes from milestones assessments may be helpful to improve our PGY program.

關鍵字

competency-based medical education ； reporting milestones

參考文獻

Carraccio C, Wolfsthal SD, Englander R, et al.: Shifting paradigms: from Flexner to competencies. Acad Med 2002;77:361-7.

Tekian A, Hodges BD, Roberts TE, et al.: Assessing competencies using milestones along the way. Med Teach 2015;37:399-402.

Green ML, Aagaard EM, Caverzagie KJ, et al.: Charting the road to competence: developmental milestones for internal medicine residency training. J Grad Med Educ 2009;1:5-20.

Weinberger SE, Pereira AG, Iobst WF, et al.: Competency-based education and training in internal medicine. Ann Intern Med 2010;153:751-6.

Hawkins RE, Welcher CM, Holmboe ES, et al.: Implementation of competency-based medical education: are we addressing the concerns and challenges? Med Educ 2015;49:1086-102.

被引用紀錄

王雅惠、林筱茹、林瓊茹、王瀅淑、王雅緻、林威宏、賴佩君、陳炯瑜（2022）。電子學習歷程與勝任能力導向醫學教育於跨專業團隊會議教學。台灣醫學，26(4)，483-491。https://doi.org/10.6320/FJM.202207_26(4).0013

Chen, C. Y., Wu, J. H., Lin, W. H., Nien, K. W., Tsai, P. J., Wang, H. T., & Lin, H. J. (2021). The Effects of Duty Hours Reform on Internal Medicine: Views from Different Levels of Practicing Medicine and Changes in Milestones Assessment Outcomes. Journal of Medical Education, 25(1), 24-34. https://doi.org/10.6145/jme.202103_25(1).0002

延伸閱讀

張光宜、潘瑛如（2021）。Performance Evaluation of the Milestone Program to Residency Training and Test Analysis of the Written Examinations for Certification in Anesthesiology。台灣教育研究期刊，2(2)，209-241。https://www.airitilibrary.com/Article/Detail?DocID=P20220316001-202103-202203240015-202203240015-209-241
黃煦恩、連育誠、林靖麒、林科名、尤珊富（2023）。Establishing the Professional Competencies of Internal Medicine Residents to Implement Shared Decision-Making Through the DMEATEL Method。內科學誌，34(2)，111-123。https://doi.org/10.6314/JIMT.202304_34(2).06
Su, C. J., Yang, Y. Y., Yang, L. Y., Hwang, L. J., Chuang, C. L., Chang, C. C., Lu, D. Y., Huang, H. C., Hwang, S. J., Kao, S. Y., & Lee, F. Y. (2018). Formative Group OSCE+OSTE Evaluates The Learning of PGY Residents in The Skills of Emergency Care, Timely Call For Help and Teaching. Journal of Medical Education, 22(3), 116-124. https://doi.org/10.6145/jme.201806.0013
楊盈盈、李發耀、徐會棋、莊喬琳、李文興、張景智、陳震寰、葉振聲、鄭浩民、黃金洲、黃加璋、戴政宏（2011）。Effects of the "Training Program for PGY1 Clinical Teacher" on Teaching and Evaluation Skills of ACGME Six Core-Competencies of PGY1 Residents。Journal of Medical Education，15(2)，120-133。https://doi.org/10.6145/jme.201106_15(2).0006
洪壽宏、胡文郁、劉文俊、邱泰源、陳慶餘、謝博生（2005）。An Interventional Study Assessing Community Medicine Learning among Residents Undertaking the Course "Post-Graduate Year One (PGY-I) General Medicine"。Journal of Medical Education，9(1)，33-45。https://doi.org/10.6145/jme.200503_9(1).0003

國際替代計量

The Implementation of ACGME ＂Reporting Milestones＂ in Internal Medicine Postgraduate Year Training Program - Experience Sharing and Preliminary Outcome

全文下載

主題瀏覽