Summary
Background
Milestones refer to points along a continuum of a competency from novice to expert.
Resident and fellow assessment and program evaluation processes adopted by the ACGME
include the mandate that programs report the educational progress of residents and
fellows twice annually utilizing Milestones developed by a specialty specific ACGME
working group of experts. Milestones in clinical training programs are largely unmapped
to specific assessment tools. Residents and fellows are mainly assessed using locally
derived assessment instruments. These assessments are then reviewed by the Clinical
Competency Committee which assigns and reports trainee ratings using the specialty
specific reporting Milestones.
Methods and Results
The challenge and opportunity facing the nascent specialty of Clinical Informatics
is how to optimally utilize this framework across a growing number of accredited fellowships.
The authors review how a mapped milestone framework, in which each required sub-competency
is mapped to a single milestone assessment grid, can enable the use of milestones
for multiple uses including individualized learning plans, fellow assessments, and
program evaluation. Furthermore, such a mapped strategy will foster the ability to
compare fellow progress within and between Clinical Informatics Fellowships in a structured
and reliable fashion. Clinical Informatics currently has far less variability across
programs and thus could easily utilize a more tightly defined set of milestones with
a clear mapping to sub-competencies. This approach would enable greater standardization
of assessment instruments and processes across programs while allowing for variability
in how those sub-competencies are taught.
Conclusions
A mapped strategy for Milestones offers significant advantages for Clinical Informatics
programs.
Keywords
Education - clinical informatics - professional training - physician - general healthcare
providers - training and education requirements
