Essential component of NAS are the MILESTONES Basis is to track development in the 6 competencies
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Essential component of NAS are the MILESTONES Basis is to track development in the 6 competencies
Dreyfus Model:- Novice- Advanced beginner- Competent- Proficient- Expert- Master
Milestones
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RRC Boards P.D.’s Residents
Milestones
Milestones Developed By
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Develop by December 2012Submission to ACGME 2013 & 2014
Milestones Will Supplement, Not Replace Existing Assessment Tools
Timeline:
Milestones
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Could you present your experience with the Milestones?
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The Orthopaedic Surgery Milestones
I. Martin Levy, MDProgram Director
Professor of ClinicalOrthopaedic Surgery
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The Milestones
are ComingHere
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The only thing we have to fear is FEAR ITSELF
…and spiders
…and maybe the milestones
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So we gathered our Chiefs of Service.
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Like everyone else, we took our toolbox and started to figure out ways to recognize a competent resident.
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We developed goals and objectives for each service.
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This was not the easy part.
But we ended up with a handbook.
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While doing our G&O’s, we started playing with technical milestones. We called them Index Procedures. We began using these Index Procedures as a way to assess achievement of independence.
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I brought these IP’s to CORD’s Technical Competency Committee. During these discussions I became aware of the ACGME Milestone Project.
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“A good plan violently executed now,is better than a perfect plan executed next week.” George S. Patton Jr.
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While not ecstatic over the knowledge that index procedures were going to morph into the more complex milestones, COS familiarity with IP’s and G&O’s made the transition less painful…for me.
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Dr. Nasca wrote his
article, NAS became a
household word and the the
Milestone Project
arrived at our doorstep.
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We were fortunate that the Orthopaedic Knowledge Base and Patient Care milestones were prescriptive and organized by subspecialty.
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Each Chief of Service was
asked to review their
service specific
milestones and discuss
feasibility.
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They have successfullycreated a curriculum that supports the knowledge base and develops the required surgical techniques and clinical skills.
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• Gets a real time review • For applicable Milestones only• And these are uploaded
Each resident on a service
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Clinical Competency Committee (C.C.C.)
Core faculty
Program director-
Chief resident
Include
Function
Function
Evaluate milestones & early warning
Track progress of residents
Faculty development
Reduce potential bias
Performance measure
Decision making by multiple people
Evaluate 360° assessments
Purpose
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So we identified our Clinical Competency Committee.
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The C.C.C. was thrilled.
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From the C.C.C. each resident receives:
• Summative evaluation• Twice a year• And these are uploaded
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At this early stage, and with what is at stake, I believe the only way to insure reliable input, is by meeting regularly with my Chiefs of Service.
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Thank you